Around the world, there is no population clear from urinary tract infection (UTI), particularly among women. UTI is considered the most predominant bacterial infection. This study aimed to detect the incidence of the most common major uropathogens in patients severe from urinary tract infection with antibiotic sensitivity tests that assist urologist doctors for appropriate antimicrobial empirical therapy.Methods: This study was carried in a private laboratory in Babil city, Iraq from May 2019 to May 2020. Totally 70 individuals suffering from clear symptoms of UTI, as well as, 20 healthy persons participated in this study as a control group. Then, the standard microbiological methods carried out to isolate and identify bacterial species. Antimicrobial susceptibility tests were performed using different antimicrobial discs by applying the Kirby–Bauer disc diffusion method.Results: Totally, 90 specimens were obtained from them 20 control group, 19 with no growth, and 51 patients with bacterial growth distributed as 43 (83%) females and 8 (17%) males. E. coli were the most common predominant organisms. All isolates were showed a high rate of resistance to evaluated cephalosporins 100% and 82% to cefotaxime and ceftriaxone respectively, while very low resistance recorded in Aminoglycosides 20% and 13% to Gentamicin and amikacin respectively. Most age group infected with UTI was 21-40 years old.Conclusion: The current study showed an increasing burden of urinary tract infection caused by various bacteria implicated in UTI that causes changeable sensitivity to various antimicrobial agents. Therefore, in clinical use appropriate medications should be selected based on the data obtained from antimicrobial susceptibility tests.

Escherichia coli is the main pathogen responsible for extraintestinal infections. A total of 196 clinical E. coli consecutively isolated during 2016 in Spain (100 from Lucus Augusti hospital in Lugo) and France (96 from Beaujon hospital in Clichy) were characterized. Phylogroups, clonotypes, sequence types (STs), O:H serotypes, virulence factor (VF)-encoding genes and antibiotic resistance were determined. Approximately 10% of the infections were caused by ST131 isolates in both hospitals and approximately 60% of these infections were caused by isolates belonging to only 10 STs (ST10, ST12, ST58, ST69, ST73, ST88, ST95, ST127, ST131, ST141). ST88 isolates were frequent especially in Spain while ST141 isolates significantly predominated in France. The 23 ST131 isolates displayed four clonotypes: CH40-30, CH40-41, CH40-22 and CH40-298. Only 13 (6.6%) isolates were carriers of ESBL enzymes. However, 37.2% of the isolates were multidrug-resistant (MDR). Approximately 40% of the MDR isolates belonged to only four of the dominant clones (B2-CH40-30-ST131, B2-CH40-41-ST131, C-CH4-39-ST88 and D-CH35-27-ST69). Among the remaining MDR isolates two isolates belonged to B2-CH14-64-ST1193 i.e the new global emergent MDR clone. To our knowledge, it is the first identification of this emergent clone in Spain. Moreover, a hybrid ExPEC/enteroaggregative isolate belonging to A-CH11-54-ST10 clone was identified.

Whistler mode waves play a major role in regulating the lifetime of trapped electrons in the Earth's radiation belts. Specifically, whistler mode hiss waves are one of the mechanisms that maintains the slot region between the inner and outer radiation belts. The generation mechanism of hiss is a topic still under debate with at least three prominent theories present in the literature. Lightning generated whistlers in their ducted or non-ducted modes, are considered to be one of the possible sources of hiss. We present a study of new observations from the Radio Receiver Instrument (RRI) on the Enhanced Polar Outflow Probe (ePOP: currently known as SWARM-E). RRI consists of two orthogonal dipole antennas, which enables polarization measurements, when the satellite boresight is parallel to the geomagnetic field. Here we present 75 passes of ePOP - RRI from 2014 - 2018, in which lightning whistlers and hiss waves were observed. In more than 50% of those passes hiss is found to co-exist with the lightning whistlers. Moreover, the whistler observations are correlated with observations of wave power at the lower-hybrid resonance. The observations and a whistler mode ray-tracing study suggest that multiple-hop lightning induced whistlers can be a source of hiss and plasma instabilities in the magnetosphere.

Although the complexity of physically based models continues to increase, they still need to be calibrated. In recent years, there has been an increasing interest in using new satellite technologies and products with high resolution in model evaluations and decision-making. The aim of this study is to investigate the value of different remote sensing products and groundwater level measurements in the temporal calibration of a well-known hydrologic model i.e. HBV. This has been rarely done for conceptual models as satellite data are often used in spatial calibration of the distributed models. Three different soil moisture products from ESA CCI SM v04.4, AMSR-E and SMAP, and total water storage anomalies from GRACE are collected and spatially averaged over the Moselle River Basin in Germany and France. Different combinations of objective functions and search algorithms all targeting a good fit between observed and simulated streamflow, groundwater and soil moisture are used to analyse the contribution of each individual source of information. Firstly, the most important parameters are selected using sensitivity analysis and then, these parameters are included in a subsequent model calibration. The results of our multi-objective calibration reveal substantial contribution of remote sensing products to the lumped model calibration even if their spatially distributed information is lost during the spatial aggregation. Inclusion of new observations such as groundwater levels from wells and remotely sensed soil moisture to the calibration improves the model’s physical behaviour while it keeps a reasonable water balance that is the key objective of every hydrologic model.

The protection of electronics against environmental influences and mechanical loads is important for integration of conventional electronics in textile conductive tapes. For this purpose, the sensors on the tapes are molded with plastic locally. This process step is recognized in the injection molding process. The molding compound is then later selected depending on: The field of application, the parameters of the manufacturing process and the textile tape properties. We have designed a mould for liquid silicone (LSR) as well as for the textile and electronic insertions. The cavities are sealed by a local compression of the textile and the two inserts are positioned with position pins representing the main aspect of the mould design. The sampling tool and the process parameter optimization are mainly based on the material properties of the silicone and the mechanical sensitivity of the inserts. To reduce the deformation of the circuit boards by the melt front and ensuring the functionality of the electronics a low-pressure process is used.

The Rybczynski theorem describes the trade effect within production analyses between factor endowments and outputs. The Stolper-Samuelson theorem focuses on cost analyses between factor reward and commodity price. This paper examines the trade effect of changes of factor endowments on prices, based on general equilibrium. The study shows that changes of factor endowments cause domestic output changes (the Rybczynski effect), which affect output prices and factor prices (the Stolper-Samuelson effect). It is like a chain of effects that the Rybczynski’s trade effect triggers the Stolper-Samuelson’s trade effect. The analysis of this paper shows that a small increase of a factor endowment of any country rewards another factor and the commodity using the latter factor intensively. It displays a tuneful circle. Trade brings a well-balanced development to the world.

Functional ZnO nanostructured surfaces are important in a wide range of applications. Here we report facile fabrication of ZnO surface structures at near room temperature with morphology resembling that of sea urchins, with densely packed, μm-long, tapered nanoneedles radiating from the urchin centre. The ZnO urchin structures were successfully formed on several different substrates with high surface density and coverage, including silicon (Si), glass, polydimethylsiloxane (PDMS), and copper (Cu) sheets, as well as Si seeded with ZnO nanocrystals. Time-resolved SEM revealed growth kinetics of the ZnO nanostructures on Si, capturing the emergence of “infant” urchins at the early growth stage and subsequent progressive increase in the urchin nanoneedle length and density, whilst the spiky nanoneedle morphology was retained throughout the growth. ε-Zn(OH)₂ orthorhombic crystals were also observed alongside the urchins. The crystal structures of the nanostructures at different growth time were confirmed by synchrotron X-ray diffraction measurements. On seeded Si substrates, a two-stage growth mechanism was identified, with a primary growth step of vertically aligned ZnO nanoneedle arrays preceding the secondary growth of the urchins atop the nanoneedle array. The antibacterial, anti-reflective, and wetting functionality of the ZnO urchins—with spiky nanoneedles and at high surface density—on Si substrates was demonstrated. First, bacteria colonisation was found to be suppressed on the surface after 24 h incubation in Gram-negative E. coli culture, in contrast to control substrates (bare Si and Si sputtered with 20 nm ZnO thin film). Secondly, the ZnO urchin surface, exhibiting superhydrophilic property with a water contact angle ~0°, could be rendered superhydrophobic with a simple silanization step, characterised by a water static contact angle θ of 159° ± 1.4° and contact angle hysteresis ∆θ < 7°. The dynamic superhydrophobicity of the surface was demonstrated by bouncing-off of a falling 10 μL water droplet, with a contact time of 15.3 milliseconds (ms), captured using a high-speed camera. Thirdly, it was shown that the presence of dense spiky ZnO nanoneedles and urchins on the seeded Si substrate exhibited a reflectance R < 1% over the wavelength range λ = 200–800 nm. The ZnO urchins with unique morphology via a facile fabrication route at room temperature, readily implementable on different substrates, may be further exploited for multifunctional surfaces and product formulations.

Abstract Introduction: Antimicrobial resistance (AMR) is a recognised public health threat today globally. Though many active and passive stewardship strategies are employed to counter AMR clinically, educating school going children on AMR could be a futuristic cost-effective measure to minimize AMR development. We hypothesised NICE’s e-bug module to class VII school students on AMR determinants. Methodology: A prospective non-randomized intervention study on 327 students belonging to 9 schools of class VII around Manipal town, Udupi district, Karnataka state, India were included for the study. 10 questions on AMR determinants extracted from NICE’s e-bug program were quizzed in written as pre-test followed by an education intervention on the same questions followed by a post-test to end the session. Descriptive statistics to estimate epidemiological characteristics, Wilcoxon Signed Ranks and Kruskal-Wallis tests were applied to analyse statistical significance of pre/post-test performance scores for the 10 questions and between schools respectively Results: Students had inadequate knowledge on 7 AMR determinants (antimicrobial indication, its course, hand hygiene, fermentation, spread of infection, microbial multiplication and characteristics of microbe) when analysed for post-test performance (p<0.05). Comparison of post-test performance of 9 participating schools revealed statistical significance (p<0.05) for 3 questions (definition on antimicrobial, cover while cough/sneezing and microbial characteristics) Conclusion: Although students exhibited sub-optimal knowledge on few AMR determinants, they showed keenness to learn exhibited by their performance. Our findings and previous similar studies from Europe are suggestive of early pedagogic interventions on AMR through inclusion of such education modules in the curriculum could be potential tool for AMR prevention for future generations.

Electronic Nose (eNose) systems are particularly appreciated for their portability, usability, relative low cost and real-time or near real-time response. Their application finds space in several domains, including environmental monitoring. Within this field, marine monitoring is of particular scientific relevance due to the fragility of this specific environment, daily threatened by human activities that can potentially bring to catastrophic and irreversible consequences on marine wildlife. Under such considerations, a systematic review, complying with the PRISMA guidelines, was conducted covering the period up to October 15, 2018, in PubMed, ScienceDirect and Google Scholar. Despite the relatively low number of articles published on this specific topic and the heterogeneity of the technological approaches employed, the results obtained by the various groups highlight the positive contribution eNose has given and can provide in near future for the monitoring and safeguarding of this delicate environment.

Although there are extensive literature reports on the use of gold nanoparticle (AuNP) based homogeneous assays for detection of biomolecules, very few experimental description and procedures involving their preparation are described. In this study, AuNPs conjugated to Bovine Serum Albumin or Envelope protein from Dengue II were developed as a homogeneous immunoassay for antibody detection. We report here optimization of key parameters to prepare an immunoassay like conjugation protein concentration, centrifugation time, electrolyte addition and assay temperature. We determined that saturating protein concentrations improved AuNPs surface coverage and uniformity of the assay and addition of sodium chloride improved sensitivity of the antibody detection method and assay stability. Furthermore, we showed that dynamic light scattering can be used to monitor changes in gold nanoparticles in the preparation and detection steps. Additionally, numerical simulations of the plasmonic optical response of AuNPs were carried out to scan for size-dependent response of the AuNPs. The AuNPs homogeneous immunoassay developed was further used in the detection of antibodies in vitro to detect Dengue virus infection.

Accurate estimates of daily rainfall are essential for understanding and modeling the physical processes involved in the interaction between the land surface and the atmosphere. In this study, daily satellite soil moisture observations from the Advanced Microwave Scanning Radiometer - Earth Observing System (AMSR-E) generated by implementing the standard NASA- algorithm are employed for estimating rainfall, firstly, through the use of recently developed approach, SM2RAIN (Brocca et al., 2013) and, secondly, the nonlinear autoregressive network with exogenous inputs (NARX) neural modelling at five climate stations in the Karkheh river basin (KRB), located in southwest Iran. In the SM2RAIN method, the period 1 January 2003 to 31 December 2005 is used for the calibration of algorithm and the remaining 9 months from 1 January 2006 to 30 September 2006 is used for the validation of the rainfall estimates. In the NARX model, the full study period is split into a training (1 January 2003 to 31 September 2005) and a testing (1 September 2005 to 30 September 2006) stage. For the prediction of the rainfall as the desired target (output), relative soil moisture changes from AMSR-E and measured air temperature time series are chosen as exogenous (external) inputs in NARX. The quality of the estimated rainfall data is evaluated by comparing it with observed rainfall data at the five rain gauges in terms of the correlation coefficient R, the RMSE and the statistical bias. For the SM2RAIN method, R ranges between 0.44 and 0.9 for all stations, whereas for the NARX- model the values are generally slightly lower. Moreover, the values of the bias for each station indicate that although SM2RAIN is likely to underestimate large rainfall intensities, due to the known effect of soil moisture saturation, its biases are somewhat lower than those of NARX. In conclusion, the results of the present study show that with the use of AMSR-E soil moisture products in the physically based SM2RAIN- algorithm as well as in the NARX neural network, rainfall for poorly gauged regions can be fairly predicted.

Apoptosis and cell cycle arrest induction are targeted in the strategy of cancer therapy. Furthermore, bacterial toxin such as shiga-like toxin producing Escherichia coli has been suggested to be used as novel therapeutic agent against tumor malignancies either as independent anti-neoplastic agents or in combination treatment with chemo or radiotherapy. The aim of study was to investigate the potency of shiga-like toxin originated from local strains of E. coli O157:H7 as a new cancer therapy. As many as 10 culture cells T47D cell line were subjected by crude extract Shiga like toxin originated from five local isolates of E. coli O157:H7 i.e. KL-48(2), SM-25(1), SM-7(1), DS-21(4), and one isolate ATCC 43894 as a control with IC50 doses, respectively. The treatment was observed for 24 h, with two replications. An FITC-Annexin V and PI assay was used to observe apoptosis and necrosis effect, and simultaneously with cell cycle analysis using propidium iodide (PI) staining. Results of study showed T47D cell treated with Shiga-like toxin from local strain KL-48 (2) show the lowest viable cell, followed by SM 7(1), ATCC 43894, SM-25(1), DS-21(4) and contrary with control with each percentages as 15.20, 16.36, 22.17, 22.64, 33.86, and 94.36%, respectively. The results were also confirmed by the induction of the cell cycle arrest in phase G0-G1 as inactive phase, i.e. 66.41, 63.37, 61.52, 55.36 and 47.28% for T47D cell treated with toxin of KL-48(2), ATCC 43894, SM 25(1), SM 7(1), and DS 21(4), respectively. These results show tendency deleterious effect of Shiga-like toxin from local isolates on T47D cell, so that concluded they have potency as a good anticancer drug in Gb3-expressing breast cancer.

Burden of diseases measured as disability-adjusted life years per 100,000 people can be mined from public domain data, when they are made available by population health surveillance systems. This can be analysed to allow insightful comparisons with the national average, and to understand differences in trends between the sexes, age groups, time periods, geographic regions and sub-regions. In this illustrative case study, we have analysed the Scottish burden of disease database to understand what ailed the population of the Grampian region before the COVID-19 pandemic. We have identified selected cancers, ischaemic heart disease, Alzheimer’s disease and other dementias amongst the highest contributors to the burden; that drug use disorders and colorectal cancer are showing worsening trends and require health promotion and disease prevention measures from ages 15 and 25 respectively, especially in Aberdeen City; and that males are more vulnerable to atrial fibrillation and flutter, diabetes mellitus and oesophageal cancer, while females are to cerebrovascular disease. We demonstrate the usefulness of our analysis and methodology for the wider health system, allowing targeted medical research investments and coordinated response from public health and health service delivery. We also show the need for up-to-date surveillance data, forecasts and evidence on the impact of interventions to be made available widely.

Fungal infections (FIs) are spreading globally causing a significant public health concern. However, its documentation remains sparse in Africa, particularly in Rwanda. This literature review, aims to assess the risk and document current gaps in evidence and policy. It summarizes the published data about FIs in Rwanda, including ten reports published between 1972-and-2022. Blastomyces, Candida, Cryptococcus, Histoplasma, Microsporum, Pneumocystis, Rhinosporidium, and Trichophyton caused human infections. These infections primarily affected the brain, respiratory, urinary and reproductive organs, and they were diagnosed using culturing, histopathology, immunology, and/or microscopic techniques. Our findings provide an overview of the diversity and distribution of FIs, highlighting significant limitations in the country’s diagnostic capacity and surveillance system for FIs. Also, indicating severe gaps in evidence to inform policymaking, guide strategic planning and intervention, underscoring the urgent need to build national capacity in fungal diagnosis, surveillance, and research. Raising awareness among the public, scientific community, healthcare providers, and policymakers remains crucial. Furthermore, this report reveals the threats of FIs on public health and food insecurity in Rwanda. A Multisectoral One Health Strategy is essential in research and intervention to determine and reduce the health and safety impacts of fungal pathogens on human, animal, and the environment.

Accountable Care Organizations (ACOs) are healthcare delivery systems that aim to coordinate and improve the quality of care for patients while reducing costs. ACOs bring together doctors, hospitals, and other healthcare providers to work as a team to care for a defined population of patients. The idea behind ACOs is to shift the focus from paying for each individual service provided to patients, known as fee-for-service, to paying for the overall care and well-being of patients.ACOs typically operate under a shared savings model and also encourages providers to use data and technology to better coordinate care and improve patient outcomes.ACOs can be physician-led organizations, hospital-led organizations, and collaborations between healthcare providers. The success of ACOs depends on many factors, including the level of cooperation and collaboration among healthcare providers, the quality of care provided, and the ability to effectively manage costs.Despite their potential benefits, ACOs also face challenges, including the difficulty of coordinating care across multiple healthcare providers, the need to invest in technology and data management systems, and the challenge of changing provider behavior.This study assessed a number of systemic reviews and journals to assess the impact of ACO’s on population health. ACO’s have shifted away from costly care patterns and thus helped many countries.

The climate crisis is developing to a life-changing event on a global level. Health promotion with the aim to increase the health status of individuals, independent from the present health status has been developed on scientific basis at least for the last eight decades and follows. There are some basic principles, which are prerequisites for both, health promotion and climate protection. Those principles include (1) sustainability, (2) orientation on determinants, and (3) requirement of in-dividual as well as community approaches. People are generally aiming to protect their lifestyle habits (e.g. traveling, consumer habits) and personal properties (e.g. car, house) by easy solution with as little effort as possible, and this can affect both, health and climate. To reduce the emission of greenhouse gases and to protect our environment, changes towards a sustainable lifestyle have to be embed into everybody’s mind. Examples for domains, that need to be addressed in health promotion as well as in climate protection include education/ knowledge/ (health) literacy, physical activity, nutrition and dietary habits, mental health, and social capital. If health promo-tion fails to tackle those domains, this will continue to drive climate crisis. And climate change, in turn, will affect health. On the other hand, developing and promoting health resources in the domains mentioned could again help to mitigate the health-damaging effects of climate change.

The study aimed to identify clinical pharmacology patterns of prescribed and taken medications in older cardiovascular patients using electronic health records (EHRs) (n = 704) (2019–2022). Medscape Drug Interaction Checker was used to identify pairwise drug-drug interactions (DDIs). Prevalence rates of DDIs were 73.5% and 68.5% among taken and prescribed drugs, respectively. However, total number of DDIs was significantly higher among prescribed medications compared with the list of taken drugs (p < 0.05). Serious DDIs comprised 16% and 7% of all DDIs among prescribed and taken medications, correspondingly (p < 0.05). Median DDI numbers between prescribed versus taken medications were Me = 2, IQR 0-7 and Me = 3, IQR 0-7 per record, respectively. Prevalence of polypharmacy was significantly higher among prescribed medications compared with taken medications (p < 0.05). Women were taking significantly more drugs and had higher rates of polypharmacy and DDIs (p < 0.05). No sex-related differences were observed in the list of prescribed medications. ICD code U07.1 (COVID-19, virus identified) was associated with the highest median DDI number per record. Further research is warranted to improve EHR structure, patient engagement in reporting adverse drug reactions, and genetic profiling of patients to avoid potentially serious DDIs.

Semantic interoperability facilitates exchange and access of health data that is being documented in EHRs with various semantic features. In the EU, the regulation proposal of European health data space requires development of semantic interoperability. To achieve a fully integrated EHDS ecosystem leveraging the value of health data, stakeholders need to overcome challenges of implementing common standards and other semantic interoperability features. We aimed to research what scientific evidence is available on developing semantic interoperability. Our research questions focused specifically on key features and approaches for semantic interoperability and on possible benefits of these choices. For that purpose, we performed a systematic literature review by defining our study framework based on previous research. Our results consisted of 10 studies where data models, ontologies, terminologies, classifications, and standards were applied for building interoperability. Through increased access to interoperable patient information, a better quality and outcomes in care can be achieved. Better communication based on easily accessible data is facilitated between health professionals and between clinicians and the patients. When heading towards semantic harmonization as outlined in the EHDS proposal, more experiences and analyses are needed to assess how applicable the chosen solutions are for semantic interoperability of European health care data.

The practice of nurse health coaching (NHC) draws from the art and science of nursing, behavioral sciences, and evidence-based health coaching methods. This secondary analysis of the audio-recorded natural language of participants during NHC sessions of our recent 8-week RCT evaluates improvement over time in cognitive-behavioral outcomes: Change Talk, Resiliency, Self-Efficacy/Independent Agency, Insight & Pattern Recognition, and Building Towards Sustainability. We developed a measurement tool for coding, Indicators of Health Behavior Change (IHBC), that was designed to allow trained health coach experts to assess the presence and frequency of the indicators in the natural language content of participants. We used a two-step method for randomly selecting the 20-minute audio-recorded session that was analyzed at each time point. Fifty-six participants had high-quality audio recordings of the NHC sessions. Twelve participants were placed in the social determinants of health (SDH) group based on the following: low income (<$20,000/year), early-onset hypertension, and social disadvantages. Our analyses significantly improved Change Talk and the other four factors over time. Our factor analyses indicated two distinct factors at each measurement point of the study, demonstrating the stability of the outcome measures over time. Our newly developed measurement tool, IHBC, proved stable in structure over time and sensitive to change. This NHC program shows promise in improving cognitive-behavioral indicators associated with health behavior change in both non-SDH and SDH individuals.

Background: During the COVID-19 pandemic some family physicians were overburdened and experienced difficulties reaching vulnerable patients and meeting the increased need for psycho-social support. This randomized controlled trial (RCT) tested whether a primary healthcare (PHC) based community health worker (CHW) intervention could tackle psychosocial suffering due to physical distancing measures in patients with limited social networks. Methods: CHWs provided 8 weeks of tailored psychosocial support to the intervention group. Control group patients received ‘care as usual’. The impact on feelings of emotional support, social isolation, social participation, anxiety and fear of COVID-19 were measured longitudinally using a face-to-face survey to determine their mean change from baseline. Self-rated change in psychosocial health at 8 weeks was determined. Results: We failed to find a significant effect of the intervention on the prespecified psychosocial health measures. However, the intervention did lead to significant improvement in self-rated change in psychosocial health. Conclusions: This study confirms partially the existing evidence on the effectiveness of CHW in-terventions as a strategy to address mental health in PHC in a COVID context. Further research is needed to elaborate the implementation of CHWs in PHC to reach vulnerable populations during and after health crises.

The present short communication aimed to determine the effects of vegetable cultivation on health. We conducted a qualitative study using responses to an open-ended question that was part of a survey on regional differences on vegetable intake. Participants in this study were residents of Gunma Prefecture, Japan, and were aged between 20–74 years. In the questionnaire, we asked: “Aside from increasing vegetable intake, how does vegetable cultivation affect your health?” We were able to categorize the answers into six subcategories related to physical health, mental health, and social well-being.

Background: The COVID-19 pandemic led to rapid growth in telemental health services and investment in digital mental health technologies. Digital mental health technologies could expand access to mental health care amid increasing provider deficit by providing tools for expedited psychiatric symptom assessment and treatment augmentation. This systematic review explores the recent evidence for the use of scalable digital tools, including virtual reality, neurofeedback training, wearables, mobile apps, digital phenotyping, and machine learning for PTSD symptom assessment, diagnosis, and treatment. Methods: A PubMed search identified studies on digital technologies with current or future potential for scalability (accessible through a small, digital device without the virtual or in-person presence of a mental health care provider)–and PTSD diagnosis, symptom assessment, or symptom treatment as the primary outcome. Thirty-five studies inform this review. Results: Virtual reality exposure therapy is efficacious for combat-related PTSD treatment. Conclusions of studies investigating apps and neurofeedback training are limited by low sample size and methodological heterogeneity. Machine learning models demonstrate capability in detecting PTSD symptoms via passively collected data from smartphones, wearables, and actively collected data from patient speech, writing, and videos, but standardization of data collection and modeling are needed before application to clinical settings. Conclusions: Advancements in scalable digital tools could address barriers in healthcare access and improve patient engagement by providing asynchronous assessment and treatment augmentation. Future research utilizing diverse patient populations in standardized controlled trials is needed to determine evidence-based protocols for implementation.

A cross-sectional study was organised to investigate the range, prevalence, and associated factors for occupational health problems related to dental practice among Cambodian dentists; Participants underwent a face-to-face interview to explore dentists work-related health problems; 106 Cambodian dentists participated in this study, 68.9% were male. Ages ranged from 29 to 71 years, averaging 36.1 years, with the majority (77.4%) in the 29-40 age group. They had 5 to 18 years of practice experience, and worked an average of 52.2 hours per week. Commonly reported health issues included back pain (88.7%), headaches (81.1%), shoulder pain (78.3%), arm/hand pain (57.5%), and eye problems (48.1%). 38.7% of participants felt stressed and 19.8% depressed. Some reported suicidal thoughts and taking medication for depression. Despite these challenges, 91.5% enjoyed practicing dentistry; Findings highlight the need for interventions and strategies to address the physical and mental well-being of Cambodian dentists. By addressing these issues, steps can be taken to enhance the working conditions and professional satisfaction of dental professionals, ultimately benefiting both the practitioners and their patients.

This paper reports data from three sources showing young people’s positive responses to the population-wide Act-Belong-Commit mental health promotion campaign: (i) impact on 14-25 year old participants in a peer-educator workshop program; (ii) impact on 11-14 year old student participants in an adaptation of the campaign in secondary schools (the ‘Mentally Healthy Schools Framework’); and (iii) impact of the population wide media-based campaign on 18-24 and 25-34 year olds in the general population (versus those 35+ years). Overall, these findings support the conclusion that mental health promotion interventions can be based on underlying constructs relevant across the lifespan and then tailored for specific ages and settings rather than requiring the development of separate, distinct programs based on different constructs for younger age groups.

The effects of climate change health impacts on urban health care systems and vulnerable populations are a researched topic with foundations on urban risk management, urban health methodologies, and sustainable urbanization. As climate change is a dynamic and transformative global issue the gap between adaptation and mitigation efforts and urban planning relies, among other things, in the limitations of previous studies of risk management structures tailored to the existing strategy to calculate the uncertainties and predict their influence on urban systems and subsystems. Moreover, as climate and health is a well-researched issue, it is also complex as the methodologies and strategic approach to minimize health risks of climate change is intrinsically contingent to risk methodologies and policy-making processes that are efficient with support of knowledge-based information. This paper emphasis the need for focusing on urban health risk management methods that serves to identify potential opportunities, and then manage and take action to prevent adverse health effects. It also emphasizes the probability of events and their consequences, which are measurable both qualitatively and quantitatively.

Background: In 2020, health providers were expected to provide care to individuals with coronavirus disease 2019 (COVID-19) putting them at risk of acquiring COVID-19. The possibility of acquiring poorly understood infectious diseases while providing care may have an impact on the mental health of providers. We conducted a study to explore the effects of COVID-19 on the mental health of healthcare providers. Methods: Between April and August 2021, we conducted in-depth interviews with 60 health providers in the infectious disease unit (IDU) and other units in the hospital (non-IDU). Health providers completed an online self-administered survey form with demographic data (age, sex, average income, and known contact with a COVID-19 patient). We used semi-structured interview guides to understand health providers’ lived experiences with stress, anxiety, depression, and their associated factors. We transcribed interviews verbatim, coded and analyzed the transcripts to derive thematic concepts related to mental health experiences. Results: Health providers had a median age of 37 years, [IQR 20.0-58.0], 56.7% were female, 30.0% nurses, 18.3% medical doctors, and 11.7% laboratory technologists. Health providers reported increased stress during the pandemic attributed to high demand for patient care, changes in social life, and fear of COVID-19 infection. They also reported experiences of anxiety and depression as a result of limited knowledge at the beginning of the pandemic and the perception that ‘COVID-19 resulted in death’. Testing positive for COVID-19, high exposure to COVID-19 risks, and death of patients and colleagues reportedly affected health providers’ mental health. Additionally, health providers reported mental health support through debriefing meetings, peer-to-peer support, and psychological counseling with privacy and confidentiality concerns. Conclusion: Health providers faced mental health issues such as stress and anxiety while taking care of COVID-19 patients. An effective mental health response requires institutional practices that address context-specific challenges such as privacy and confidentiality.

The COVID-19 pandemic, which has affected the entire world, has not only created a number of emerging issues for each country, especially in the field of public health, but has also provided a number of opportunities for risk management, alternative strategies and completely new ways of looking at challenges. This paper examines the COVID-19 pandemic response in Türkiye and the possible implications of the experience for future responses to other health emergencies and disaster risk management, based on the lessons learned. This study uses publicly available literature from government, private sector, and academic sources to analyse the conflicts, changes and lessons learned during the COVID-19 pandemic, which are components of the World Health Organization (WHO) Health Emergency and Disaster Risk Management (Health EDRM) framework. The COVID-19 experience in Türkiye has several aspects, including the significant role of healthcare workers, the existence of an effective health system accustomed to emergencies, applications based on information technologies, partial transparency of public authorities in providing information, and socio-cultural environment related to cooperation on prevention strategies, including wearing masks and vaccination. Challenges in Türkiye include distance learning in schools, lockdowns that particularly affect the elderly, ensuring environmental sustainability, hesitation about the effectiveness of social/financial support programmes, socio-cultural trivialisation of pandemics after a while, and relaxation of prevention strategies. Lessons learned from the COVID-19 pandemic include the value of transparency in public health/healthcare information, the strengthening of all aspects of the health system in terms of health workers, and the importance of a balanced economy prepared for foreseeable risks.

To describe the main health surveillance strategies for the control of COVID-19 in Brazil, with emphasis on decisions and actions taken at the federal level to prevent the infection caused by the new SARS-CoV-2. This is a scoping review study carried out from November 2019 to January 2021 using the DECS and MeSH health descriptors in Portuguese and English in four databases, in addition to the legislation found on the Brazilian Government's legislation portal. Based on the analysis of the documents, the actions describe non-pharmacological and pharmacological measures, measures related to decisions on closing and opening international borders, the acquisition of supplies and essential services. Although some strategies for containing the pandemic were identified, discrete and unnoticed surveillance measures are observed in view of the number of cases and number of deaths during the period of research analysis. The results show the absence of the federal level as support for the states and municipalities and imply decision-making and planning of actions by the Unified Health System to control the pandemic.

Background and objective: Research shows that 60–90% of school children have caries, representing a serious public health issue. Here, we present a model of oral health promotion that has been conducted in the Primorje-Gorski Kotar County (PGC), Croatia, from 2008 to 2019. We assessed the oral status of first and fifth grade elementary students and determined the sustainability and influence of our model on the status and behavior regarding the children’s oral status. Additionally, during the observed period, promotional and preventative activities aiming to improve oral health were conducted. Since 2014, the Program has begun to be continuously, comprehensively, and systematically introduced into preschools as well. Material and methods: We assessed the number of children with caries by analyzing the changes in the decayed, missing, and filled teeth for primary teeth (dmft)/decayed, missing, and filled teeth for permanent teeth (DMFT) index mean during the observed period. Results: From 2008 to 2019 we assessed 44422 children in the PGC (21714 first grade and 22708 fifth grade students). The average response rate throughout the Program has been 83%. We have noted a dmft/DMFT index decrease from 4,66 to 3,73 (first graders) and from 2,50 to 1,00 (fifth graders). Conclusions: The Program has improved the behavior and oral health of children; stakeholders from various professions have been included, such as health visitors, school medicine teams, and pediatricians, avoiding additional financial expenses, increasing the number of children in care, and proving the sustainability of our oral health improvement model.

Objectives This article focuses on exploring the evolution of Palliative Care in Portugal. Ten years after the approval of its Basic Law, the aim was to investigate the quality of the path followed and the guidelines that could promote its development. Thus, this study sought to identify a) the goals of the current members of parliament concerning Palliative Care, b) the major priorities that should guide the development of Palliative Care in the coming decade, c) the facilitating or hindering factors to accelerating the process, and d) to propose consensually agreed measures for an integral development of Palliative Care within the health system. Methods Qualitative data analysis was performed from the reading of literature and interviews conducted via Zoom with several intentionally chosen participants, leading to the creation of a Focus Group. The NVivo® 10 was used for data processing and categorisation. Results Three key themes emerged concerning the current status of palliative care: the policymakers, the technicians, and the society. This first line of structuring is explained by a second set of categories, namely, a) knowledge about palliative care; b) Palliative care organisation from the policymakers’ perspective. In the technicians' domain: a) knowledge about palliative care, b) clinical training, and c) medical specialty. Finally, in society: a) knowledge about palliative care. Significance of the Results Advancing general education, increasing qualitative training for the different health professionals, reformulating laws supporting them, promoting flexibility of the implementation methodologies, and establishing medical specialty, are crucial to achieving the proposed goal.

Access to maternal healthcare services is a challenge in most low and middle-income countries. South Africa is one of the countries striving to improve the accessibility of maternal healthcare services. Although South Africa has put some interventions to improve the accessibility of maternal healthcare services, vulnerable women including women with disabilities are still facing numerous challenges when trying to access maternal healthcare services. The aim of the study was to explore the experiences of women with disabilities in the province of KwaZulu-Natal in South Africa in accessing public maternal healthcare services. Twelve women with disabilities (four with physical impairments, four with hearing impairments and four with visual impairments) were interviewed for this study. Data were transcribed verbatim and analysed utilising the Framework of Assessing Access to Maternal Healthcare Services by Peters et al. 2008. The study found that narrow passages and information in inaccessible formats were a challenge for women with visual impairments. The women with hearing impairments had challenges in communication as most facilities did not have sign language interpreters, negative attitudes of health care workers and being ignored when they asked for help. The women with physical impairments encountered inaccessible buildings, narrow passages, small consultation rooms and equipment which is not adjustable such as beds and scales.

Mobile software applications (apps) have transformed how individuals oversee and maintain their own health. One way that girls can monitor their menstrual cycles is through the increasingly widespread use of mobile menstrual tracking apps. This study aims to examine menstrual symptom tracking for adolescents in English and Chinese apps, exploring menstrual literacy, cross-cultural differences, and framing, or presentation, of symptoms. The mixed methods content analysis involved 15 popular free menstrual tracking apps in English (n = 8) and Chinese (n = 7). Quantitative analysis of qualitative data was conducted through manual coding of content and automatically analyzing sentiment, or emotional tone, using a computational approach. We found that: (1) Menstrual literacy on symptom management or treatment was generally insufficient, (2) There were more available emotional than physical symptoms in English than Chinese apps, (3) Symptoms were framed more negatively than positively, somewhat more in Chinese than English apps. Findings emphasize the importance of improving information in digital menstrual trackers. Our findings further reflect cultural differences in emotional expression and negative attitudes toward menstruation. Since adolescence is a critical developmental stage that requires ample support, digital menstrual trackers can uniquely shape attitudes and experiences, ultimately, empowering teenagers to better manage their menstrual health.

Introduction: As the paramedic profession continues to grow and evolve, a shift from reactive to holistic patient care models is required. As the first and often the only point of medical contact for many patients from marginalized and under-served populations, the paramedic role, and its potential future implications in caring for these patients needs to be explored. Aim: The objective of this scoping review was to explore the paramedic's role in caring for people who use illicit drugs. Methods: A scoping review of English language literature published since 2002 was conducted using CINAHL, MEDLINE, EMBASE, and Google Scholar. We used a previously published paramedic search term filter for sensitivity combined with search terms related to drug-related substance use and addiction. Studies were selected based on relevance to the research question. Results: A total of 104 peer-reviewed and 14 grey literature articles were selected for inclusion. The main finding of this scoping review is the notable lack of evidence base surrounding the contemporary paramedic role in the care provision of people who use drugs (PWUD). The results highlight high rates of mortality following a paramedic-attended drug poisoning event, presenting a unique opportunity for paramedics to intervene in meaningful ways that extend past traditional drug poisoning response. Conclusions: The interface between the community of PWUD and the paramedic may be a highly influential encounter during a patient's journey through the healthcare system. The evolving role of the paramedic in this encounter requires focused study and should be viewed as a research priority in response to the ongoing drug poisoning crisis.

This study aims to understand the temporal and spatial characteristics of public concern for "children's mental health" in China in the context of the COVID-19 epidemic. Baidu Index is a research tool to collect and analyze massive data of Chinese netizens' behaviors. Using Baidu Index as the research tool, this paper analyzes the trend and distribution of Chinese netizens' attention to "children's mental health" from December 1st, 2019 to March 20th, 2022 from three aspects of trend research, need map, and crowd portrait. The study found that since the outbreak of COVID-19, the search trend of "children's mental health" has shown a cyclical change, peak in May and valley around the Spring Festival and National Day, and stable in other periods. "Mental health", "handwritten newspaper on mental health" and "youth mental health" are the most popular buzzwords among the public. The groups concerned of "children's mental health" is mainly distributed in Guangdong, Jiangsu, Beijing, and the majority are women between 30 and 39 years old. Meanwhile, search trend for "mental health" are like that for "children's mental health." The factors influencing the search volume change of "children's mental health" include Chinese traditional holidays, Spring Festival, National Day, Chinese Mental Health Day, and policies and instructions on children's mental health issued by the PRC Ministry of Education. The public would like to know about "mental health", "handwritten newspaper on mental health" and "adolescent mental health".

(1) Background: With continuous globalization and modernization of people's lives, lifestyle has changed dramatically, with decreased physical activity and increased unhealthy eating patterns in many nations throughout the world. With the COVID-19 pandemic and changes taking place in people’s health and lifestyles around the world, the need for rehabilitation is expected to rise in the coming years.(2)Methods: This paper analyzes the integration model of sports and health care using theoretical analysis, literature reviews, logical reasoning, and other methods.(3)Results: The integration of sports and health care in China has entered the stage of practical implementation after many years of development, forming a few representative integration patterns. Governments, communities, community hospitals, hospitals, and third-party institutions are the main participants, with the community playing an important role in the integration. Pharmacies, sports venues, and schools with sufficient staff have a relatively low participation rate.(4)Conclusion: The grading treatment has been applied in health management and sports rehabilitation, based on the development of digital medicine, a government-led grading treatment model of "health management center" can promote the participation of multiple subjects in the integration of sports and health care, solving the problems existing in the current integration process to a certain extent.

Background: It is clear that breastfeeding is the gold standard of infant feeding because of the many advantages it offers to both the child and the mother. Objective: to identity the main reasons for cessation breastfeeding declares by the mother themselves during the first year. Design: A prospective cohort study was conducted, recruiting 969 newborns in a third level hospital in Spain. The main maternal variables studied were: maternal age, parity, educational level, work occupation, smoking habit, gestational age, birth, weigh, feeding type, and duration of breastfeeding. All the participants were followed for a year to determinate the duration of breastfeeding and to know the reason of the abandonment. Results: At 6 months, the percentage of maternal lactation was cut in half and only 24.6% of these mothers maintain. Mainly 15.80% of the mothers decide to give up the exclusive maternal lactation of their own free desire, and 15.41% because they suspect hypogalactia. The work cause is the third reason of abandonment in both cases. Conclusions: Our results show the need to improve the health policies of promotion, protection and support the initiation of breastfeeding. In particular, our results show the importance of the work factor with particular emphasis on improving conciliation measures.

Since its initial outbreak in late 2019, the COVID-19 pandemic has profoundly affected the global community. In addition to the negative health consequences of contracting COVID-19, the implementation of strict quarantine and lockdown measures has also disrupted social networks and devastated the global economy. As a result, there is rising concern that the pandemic has taken a toll on the mental health of the general population. To better understand its impact, an increasing number of studies examined the effects of the pandemic on mental health and psychosocial implications of enforced quarantine and lockdown. In this article, we aim to review and summarize the findings from a variety of studies that have explored the psychosociological effects of the pandemic and its impact on the mental well-being of the general population. We will also examine how various demographic groups, such as the elderly and youth, can be more susceptible or resilient to the pandemic’s mental health effects. We hope to provide a broader understanding of the underlying causes of mental health issues triggered by the pandemic and provide recommendations that may be employed to address mental health issues in the population over the long-term.

Introduction: The majority of epidemiological reports focus on confirmed cases of COVID-19. In this study, we aim to assess the health and well-being of adults not infected with Covid-19 after two months of quarantine in Morocco. Materials and methods: Two months after the declaration of quarantine in Morocco following the Covid-19 epidemic, we carried out a descriptive cross-sectional study of 279 Moroccan citizens. We used the Short Form Health Survey (SF-12) as a determinant of quality of life, which is based on eight dimensions of health. The data were collected using an electronic questionnaire distributed online. The participants also indicated their socio-demographic data, their knowledge and practices regarding the Covid-19 pandemic and whether they had chronic health problems. Results: The quality of life of all participants was moderately disrupted during the Covid-19 pandemic with a mental health score (MCS) of 34.49 (± 6.44) and a physical health score (PCS) of 36.10 (± 5.82). Participants with chronic diseases scored lower with 29.28 (± 1.23) in mental health (MCS) and 32.51 (± 7.14) in physical health (PCS). The seriousness of COVID-19 has an impact on the quality of life and health well-being of people and this impact is more marked in people with chronic health problems. Conclusion: Our results confirm the need to pay attention to the health of people who have not been infected with the virus. Our results also point out that uninfected people with chronic illnesses may be more likely to have well-being problems due to quarantine restrictions.

Students are regarded as frequent users of mobile phones which has proven to be a convenient and acceptable method to promote healthy lifestyle. Students usually engage in relatively high levels of risky behavior and make unhealthy lifestyle choices, a study that investigates how health students access health information is necessary. The study adopted a descriptive cross-sectional study which was undertaken among third-year nursing students from three nurses training institutions in Ghana. A total of 270 students participated in the study. Most of the respondents who were currently subscribers of the health messages reported that they usually received health information on reproductive health issues, nutrition, and practicing safe sex. Most of the health students revealed that they needed more information on safe sex, diet, managing weight, and stress management. The results also show that health students are likely to remember and share short messages with friends. The findings serve as an ‘eye-opener’ for health educators and mobile service providers concerning factors that should be taken into consideration when framing health text messages that will attract health students.

Background: Drinking and smoking have economic consequences and are the main risk factors of mortality and morbidity. Disease-specific deaths attributable to using substances present the primary health indicator in this study. This analysis focuses on mortality in productive age, 15 to 64 years since those deaths are considered the highest economic burden. Method: In the analytical part, data from the Registry of deaths of the Czech Republic for 1994 to 2017 were used. The number of deaths attributable to smoking and drinking was calculated using attributable fractions, based on literature review. This research aimed to reveal the gender differences in deaths attributable to drinking and smoking, according to age, and the differences in deaths regarding smoking or drinking. Results: The mortality attributable to smoking and drinking differs across age groups and genders. The highest median share of tobacco-related deaths is in the age group, 60—64 years. The highest median share of alcoholic deaths is in the age group of 50—54 years. Conclusions: There are significant differences between genders in both, smoking and drinking. A prevention program should be targeted to different age groups.

Little research has been done on occupational health ramifications of informal electronic waste (e-waste) recycling work, which is increasingly common in low- and middle-income countries, and very little is known about this in high-income countries. Our study evaluated informal and formal e-waste recycling workers in Chile, which was recently recognized as a high-income country. In 2017 we recruited 78 informal recycling workers from two cities, and 15 formal e-waste recycling workers from one recycling facility. Participants completed a questionnaire and health assessment regarding their involvement in, and potential impacts of, e-waste recycling, among other measures. Participants were primarily male, middle-aged, married with children, and had worked in e-waste recycling for an average of 12 years. Participants generally reported good health status, and chronic disease prevalence was similar to the national prevalence. Workers commonly reported exposures to several occupational stressors, including mental health stressors and noise, as well as insufficient income. Occupational injuries were common and use of safety equipment was low. No significant differences were found between informal and formal workers. Informal e-waste workers in Chile face occupational health challenges. The extent to which these issues impact the health of informal Chilean e-waste workers is unclear and warrants further research.

Background. Perinatal depression is one of the leading causes of disability in perinatal women and is highly prevalent in disadvantaged communities in LMICs. However, care capacity remains low in most LMICs. As such, we decided to find and assess a screening program that addresses perinatal mental health problems in a resource-efficient manner. This leads us to a critically appraisal of the Perinatal Mental Health Project (PMHP), a screening program based in peri-urban Western Cape Town that stresses task sharing and stepped care intervention. Method. PubMed, Ovid Medline (1946 to 2018), and Google Scholar were searched for publications until March 2018, with data or evaluation of the PMHP. PMHP website publications were used for data and interpretation. The program’s viability was evaluated based on criteria published by UK National Screening Council. The program’s impact was analyzed using published patient outcome data. Access to care was evaluated at three barriers to accessing care proposed by Gjerdingen et al. (2007). The financial model was evaluated using the “four-pillars” of sustainable organization financial management proposed by León (2001). Findings. The PMHP’s screening program viability satisfies most criteria of the UK National Screening Council, and the program’s benefits outweigh its harms. Patient self-reports indicate successful impact with several highlights in accessibility. The program also demonstrates financial sustainability and potential for scaling-up. Interpretations. The operation model of the PMHP shows satisfactory viability and sustainability. With modifications fitting local context and government cooperation, this model offers promising potential in bringing public health and economic benefits.

Previous research suggests that the economic crisis can affect mental health. The purpose of this study was to analyse the association of risk of poor mental health with various socioeconomic, demographic, health, quality of life and social support variables; and to evaluate the contribution of socioeconomic variables most affected by the beginning of the economic crisis (employment situation and income) on the changes in the prevalence of the risk of poor mental health between 2005 and 2010. A study of prevalence evolution in adult population residents of the Valencian Community in the Spanish Mediterranean was conducted. We studied 5781 subjects in 2005 and 3479 in 2010. Logistic regression models have been adjusted to analyse the association between variables. A standardization procedure was carried out to evaluate which part of the changes in overall prevalence could be attributed to variations in the population structure by age, sex, employment status and income between the years under study. The prevalence of GHQ + increased from 2005 to 2010, in both men and women. Several variables were closely associated with the risk of poor mental health (sex, age, country of birth, number of non-mental chronic diseases, social support, disability, cohabitation in couple, employment status, and income). The changes produced as a result of the onset of the economic crisis in income and unemployment (increase in low income and in unemployment rates) contributed to the increase of poor mental health risk. This could confirm the sensitivity of mental health to the economic deterioration caused by the crisis.

The research is carried out to assess factor affecting the health condition of the elderly people in the slum areas in Sylhet City. This research was quantitative type. In Quantitative approach, primary data were collected and used from the randomly selected elderly people in the Sylhet City slum areas. The secondary data were collected from many articles, documents, newspaper, magazine etc. By analyzing the survey data, it is illustrated that the slum dwellers are deprived from the basic needs. Meanwhile, elderly people can‟t fulfill their medical treatment due to their financial condition because of their work incompatibility. This study identifies the factor affecting health condition such as financial condition, lack of knowledge about proper medical facilities, communication gap between the authority and patient, unemployment, and so on. These factors also affect their health situation. Many diseases like asthma, heart disease are occurred. This study also mentions about the livelihood of slum people are so poor in condition. Due to financial condition, aged people can‟t take their proper treatment and their family member can‟t afford it. This study also understands that the people from slum areas are getting concerned about their medical care. They are easily going to the hospital and take their service because of low pricing. On the other hand, people are meanwhile stopped their treatment of financial situation. This study finds the health situation of elderly people at slum areas in metropolitan city and their consciousness.

Environmental lead exposure is a population health concern in many low- and middle-income countries. Lead is found throughout Myanmar and prior to the 1940s, the country was the largest producer of lead worldwide. The aim of this study was to examine any potential association between lead mining and adult literacy rates at the level of the 330 townships in Myanmar. Townships were identified as lead or non-lead mining areas and 2015 census data were examined with association being identified using descriptive, analytical and spatial statistical methods. Overall, there does appear to be a significant relationship between lead mining activity and adult literacy levels (P<0.05) among townships with both low access [OR= 2.701 (1.136-6.421)] as well as townships with high access to safe sanitation [OR=18.40 (1.794-188.745)]. LISA cluster maps confirm these findings. This exploratory analysis is a first step in the examination of potential environmental lead exposure and its implications in Myanmar.

Objectives: Female genital mutilation (FGM) is a significant public health problem. It is estimated around 14,700 women affected by FGM live in Switzerland, primarily among women with a history of migration. Our qualitative research investigated the sexual health of immigrant women living with FGM in Switzerland, describing their own perception of health, reproductive life and sexuality. Methods: We conducted semi-structured, in-depth interviews with a group of eight immigrant women of African origin living in Switzerland with Type III FGM (infibulation). Results: Seven of the women were from Somalia and one from Ivory Coast. All of the Somali women were mothers and married (two separated), and the Ivorian woman was a single mother. The women in our study reported a low level of sexual satisfaction and reproductive health. They affirmed their desire to improve, or at least change, their condition. Although they rarely talk with their husbands about sexual subject matter, they would like to include them more and improve dialogue. Conclusions: Specific socio-sexual management is recommended when caring for immigrant women living with FGM in order to respond to their specific health care needs. Multidisciplinary approaches may be able to offer more comprehensive health care, including facilitated communication to improve dialogue between women and health care professionals, and eventually between women and their husbands in discussing sexual matter.

In 2021, Japan's medical expenses will exceed 45 trillion yen, and the shortage of doctors, especially in remote and mountainous areas, is becoming serious, making it difficult to maintain the medical system. We have conducted a study of 800 health consultation text data. We developed an on-premise health counseling LLM system by constructing a dialogue flow based on 800 health counseling text data. We conducted a Turing test of this system using 200 test data and verified its effectiveness with three medical professionals. The Turing test was a comparison experiment between this system and a conventional LLM system. The health counseling LLM infrastructure focuses on exercise guidance and analyzes gender, height, weight, body fat percentage, and muscle mass. While the accuracy of the conventional LLM system was 87.5%, this system showed a higher accuracy of 93.1%. Although telemedicine has been slow to spread in Japan, the introduction of a health consultation system using Personal Health Record and Large Language Models has the potential to reduce the burden on physicians. In the future, we aim to improve the accuracy of the system by using Japanese language and medical-specific evaluation scales.

Health literacy is a growing research area with specific aspects and different instruments to measure health literacy. This article uses natural language processing model to analyze the academic corpora regarding seven health literacy instruments - Health Literacy Questionnaire, Mental Health Literacy Scale, Rapid Estimate of Adult Literacy in Medicine, Test of Functional Health Literacy in Adults, Health Literacy Survey, The Newest Vital Sign and eHealth Literacy Scale. We apply Structural Topic Modeling to all the abstracts of the selected academic corpora, label the topics based on their focus, and use the topic distribution with metadata to train a Random Forest algorithm for predicting yearly citations. We estimate Regression models based on the ranking of the most relevant features, which serves as a robustness check and to infer their impact on citation dynamics. We have found that Digital Health Literacy is positively associated with yearly citations, while other topics such as Functional Health Literacy and Women's Health reduce citation likelihood. Other article characteristics also have shown a significant role in the citation likelihood, such as the publication year, amount of articles and certain keywords. These findings portray the current landscape of health literacy research, highlighting literature gaps and popular topics.

Healthcare personnel must face two problems of growing importance: violence in the workplace and the loss of work ability due to ageing of the workforce. Studying the relationship between these two phenomena can help to prepare effective prevention measures. In a public health company, we asked nurses to self-assess their work ability using the Work Ability Index (WAI) and we analysed the relationship between this indicator and the violence experienced in the previous and following years. 321 out of 344 nurses (99.3%) participated. In a logistic regression model, the WAI score was a significant protective factor for violence experienced in the previous year (OR=0.94 CI95%=0.90; 0.98 p&lt;0.01) and in the following year (OR=0.88 CI95%=0.84; 0.92 p&lt;0.01). In a hierarchical logistic regression model, social support acted as a protective factor (OR = 0.87 CI95% = 0.79; 0.95 for violence experienced in the previous year), while occupational stress was a significant determinant of the risk of aggression (OR=3.65 CI95%=1.90; 7.03 in the previous year, OR=3.54 CI95%=1.801; 6.947 in the following year). The difficulties that nurses encounter in carrying out their growing work demands in an environment that is not promptly adapted to their changing physical and mental conditions can lead to an increased risk of violence. Prevention of workplace violence should include organizational and ergonomic measures that reduce stress and increase staff support and work ability.

More than 13.5 billion COVID-19 vaccine doses have so far been delivered between 2021 and 2023 through a mix of delivery platforms, with mass vaccination campaigns being the main approach. In 2022, with the most likely scenario of continued circulation of SARS-CoV-2 and the need for periodic booster doses, there was a need for countries to plan for more sustainable approaches to provide COVID-19 vaccination. In this context of uncertainty, a global tool for integrating COVID-19 vaccines into immunization programmes and primary health care was published jointly by WHO and UNICEF to respond to country needs. The guidance leveraged existing health system frameworks, proposed four steps for the COVID-19 integration journey, and identified investment areas. The development process maximized robust global stakeholder and country engagement, and the timeframe was aligned with donor funding windows to support the integration of COVID-19 vaccination. The rapid dissemination of guidance allowed its use by countries to ascertain their readiness for integrating COVID-19 vaccination and inform the development of national plans and funding applications. While progress has been made in specific areas (e.g., optimizing cold chain and logistics leveraging COVID-19 vaccination), in the context of decreasing demand for COVID-19 vaccines, reaching adult COVID-19 vaccine high-priority-use groups and engaging and coordinating with other health programmes (beyond immunization) remains a challenge. We share the learning that despite the uncertainties of a pandemic, guidance documents can be developed and used within a short timeframe. Working in partnership with stakeholders beyond immunization towards a common objective is powerful and can allow progress to be made on integrating health services and preparing better for future pandemics.

Artificial intelligence (AI)-based conversational models, such as ChatGPT, Microsoft Bing, and Google Bard, emerged as valuable sources of health information for the lay individuals. However, the accuracy of information provided by these AI models remains a significant concern. This pilot study aimed to test a new tool referred to as “CLEAR”, designed to assess the quality of health information delivered by AI-based models. Tool development involved a literature review on health information quality, followed by initial establishment of the CLEAR tool comprising five items that aimed to assess the following: completeness of content in response to the prompt, lack of false information, evidence support, appropriateness, and relevance of the generated content. Each item was scored on a 5-point Likert scale from excellent to poor. Content validity was checked by expert review of the initial items. Pilot testing involved 32 healthcare professionals using the CLEAR tool to assess content on eight different health topics deliberately designed with varying qualities. The internal consistency was checked using the Cronbach α. Feedback through the pilot test resulted in language modifications to improve the clarity of the items. The final CLEAR tool was used to assess health information quality generated through four different AI-based models in five different, yet common health topics. The AI models were ChatGPT 3.5, ChatGPT 4, Bing, and Bard, and the content generated was scored by two independent raters with Cohen κ to assess the inter-rater agreement. The final five CLEAR items were: (1) Is the content sufficient? (2) Is the content accurate? (3) Is the content evidence-based? (4) Is the content clear, concise, and easy to understand? and (5) Is the content free from irrelevant information? Pilot testing using the eight different health topics revealed an acceptable internal consistency with a Cronbach α range of 0.669–0.981. The use of the final CLEAR tool yielded the following average scores: Bing (mean=24.4±0.42), ChatGPT-4 (mean=23.6±0.96), Bard (mean=21.2±1.79), and ChatGPT-3.5 (mean=20.6±5.20). The inter-rater agreement revealed the following Cohen κ values: for ChatGPT-3.5 (κ=0.875, P<.001), ChatGPT-4 (κ=0.780, P<.001), Bing (κ=0.348, P=.037), and Bard (κ=.749, P<.001). The CLEAR tool is a brief yet helpful tool that can aid to standardize testing of the quality of health information generated by the AI-based conversational models. Future studies are recommended to validate the utility of the CLEAR tool to assess the quality of the AI-generated health-related content using a larger sample across various complex health topics.

Cell membrane-derived liposomes, termed Memposomes, serve as promising carriers for drug delivery due to their ability to closely mimic cells and efficiently target specific cells. Liposomes derived from cancer cell membranes, in particular, exhibit homologous targeting capabilities, making them potential candidates for cancer-specific drug delivery. However, the underlying mechanisms and specific proteins responsible for this homologous targeting phenomenon remain debated. This study focuses on the role of E-cadherin, a cell adhesion molecule implicated in homophilic adhesion, in influencing the homologous targeting ability of Memposomes derived from cancer cell membranes. E-cadherin expression patterns were assessed in various cell lines, categorizing them into E-cadherin-positive and -negative groups. Memposomes were produced for each group, and their targeting tendencies were evaluated. The study confirmed that E-cadherin expression significantly influenced the homologous targeting ability of Memposomes. Cell lines with higher E-cadherin expression levels exhibited a more pronounced homologous targeting effect. This research demonstrates that cell adhesion molecules, particularly E-cadherin involved in homophilic adhesion, play a pivotal role in influencing the cell targeting ability of Memposomes. The study further validates the stability, safety, and purity of Memposomes, emphasizing their potential as effective drug delivery vehicles for the development of cell-specific therapies.

This qualitative study explores the pivotal roles of trust and communication in supplier relationship management (SRM) within the e-commerce sector. Drawing on interviews and thematic analysis, the study examines how trust, comprising dimensions of competence, benevolence, integrity, and reliability, underpins collaborative partnerships and operational resilience between e-commerce platforms and suppliers. Effective communication strategies, including proactive engagement, transparent feedback mechanisms, and real-time updates via digital platforms, are identified as critical enablers for enhancing information exchange and fostering mutual understanding in SRM. Challenges such as cultural differences, technological complexities, and regulatory compliance requirements are also discussed, highlighting the need for strategic management and investment to mitigate risks and maintain trust in supplier engagements. Relational competencies such as empathy, active listening, conflict resolution, and trust-building skills are recognized as essential for navigating interpersonal dynamics and fostering collaborative relationships in e-commerce SRM. Strategically, integrating these findings into comprehensive SRM frameworks is emphasized to cultivate a positive organizational culture characterized by openness, ethical integrity, collaboration, and adaptability. This approach aims to enhance supplier relationships, drive innovation, and achieve sustainable growth in a competitive marketplace.

Supplier diversity has emerged as a critical strategy for enhancing e-commerce operations by fostering inclusivity and innovation within supply chains. This qualitative research explores the role of supplier diversity in e-commerce, examining its impact on organizational strategies, competitive advantage, and stakeholder perceptions. Through semi-structured interviews with procurement managers, diversity officers, and supply chain executives from diverse e-commerce platforms, this study identifies key themes related to the benefits, challenges, and strategic implications of supplier diversity initiatives. Findings indicate that supplier diversity significantly enhances innovation and creativity within supply chains by integrating diverse perspectives and expertise. This diversity not only enriches product development and market responsiveness but also strengthens corporate reputation and brand equity, demonstrating organizational commitment to ethical business practices and community engagement. However, the study reveals persistent challenges, including financial barriers, systemic biases, and scalability issues, which hinder the effective implementation and scalability of supplier diversity programs. Effective supplier relationship management emerges as critical for maximizing the benefits of supplier diversity, fostering trust, collaboration, and long-term partnerships with diverse suppliers. Looking forward, the future of supplier diversity lies in digital transformation, globalization of supplier networks, and integration of sustainable sourcing practices to enhance transparency, efficiency, and resilience in supply chain operations. This study contributes to the growing literature on supplier diversity by providing empirical insights and practical implications for organizations aiming to leverage diversity as a strategic asset in e-commerce and global supply chain management.

With the burgeoning growth of online retail, the issue of counterfeit products has become a significant threat to both consumer trust and brand integrity, posing challenges to sustainable market practices. Online retail platforms are promoted to redesign their channel structures and enhance brand traceability to tackle counterfeits using blockchain technology. To investigate the interactions between blockchain technology and the channel structures of online retail platforms, we design a game theory model incorporating a manufacturer with(out) blockchain participation selling products via an online retail platform that operates an agency channel and/or a reselling channel. We show that the critical trade-off of blockchain participation comprises the brand assurance effect of the blockchain, the channel competition intensification effect, and the blockchain adoption cost. The platform is capable of strategically designing the channel structure to encourage (while discouraging) blockchain participation by the manufacturer. Our analysis highlights the complementarity between blockchain participation and the channel structure. Furthermore, the effect of the consumer’s belief in the reselling channel, the commission fee in the agency channel, and the substitutability between channels are investigated in depth. The research provides valuable insights for online retail platforms and policymakers seeking to foster a sustainable and trustworthy e-commerce ecosystem.

The graphene based highly conductive and flexible devices has received momentous attraction and growth in recent years for potential multifunctional uses. The development of flexible and washable textile sensors, actuators, energy storage and energy harvesting systems. Textile fabrics coated with graphene and conductive polymers have been used for wearable self-powered e-textiles, such as tribo-electric, piezoelectric, and Thermoelectric. Herein this research, 100% woven cotton fabric is Fictionalized with graphene oxide (GO) using industrial-scale cold pad batch dyeing technique for the development of low-grade body heat into self-powered wearable e-textiles. The conductive polymer PEDOT: PSS was coated using layer by layer approach. The study demonstrates that the resultant textile electrodes showed reduced electrical sheet resistance from 2.5 MΩ to 15KΩ, with a reduced graphene oxide and further reduced to (2.5 -12.5 Ω) for conductive polymer. The sheet resistance was decreased with the number of dyeing cycles (10-15) and increased with 20 washing cycles vice versa. The study demonstrates that the sensor response and performance were improved with increasing the content percent of rGO and PEDOT: PSS. The tensile strength of as coated fabric electrodes was improved from (25.0-85.5 mPa) and fabric thickness was increased to (26-38µm) without compromising or influencing the air permeability. The resultant textile electrodes may potentially be used in smart textiles for self-powered flexible wearable generators, sensors, and energy storage. The study demonstrates that the cold pad batch dyeing method is a suitable and effective method for the fabrication of graphene-based textiles.

Background: A Morel–Lavallée lesion (MLL) is a traumatic, internal closed degloving injury that results from shearing of subcutaneous tissue away from underlying fascia, usually associated with high-velocity trauma. Case presentation: A 52-year-old man was transported to hospital for further follow-up of a superficial femoral artery injury. Examination on admission showed bruising seen around the left thigh. Contrast-enhanced computed tomography of the left thigh revealed hematoma with extravasation from a branch of the left superficial femoral artery, but no apparent aneurysms or femoral fractures. The patient was treated with compression bandages and discharged on hospital day 6. He left hospital able to walk unaided. He subsequently complained of left thigh pain with swelling and visited the hospital several times. He was treated at another outpatient clinic and was diagnosed with MLL. Single-use disposable portable negative pressure wound therapy (NPWT) was applied for about 2 months, achieving a stable wound site. Conclusion: We encountered a case of MLL successfully treated with single-use portable NPWT. This report presents the case of a patient with isolated MLL without fracture in the left thigh, in which the diagnosis was missed on initial admission. Finally, the patient received minor interventions including drainage along with tissue debridement and portable NPWT. We reviewed the relevant literature and summarize the pathogenesis, clinical manifestations, and treatment strategies for MLL. Emergency physicians require an increased understanding of MLL to avoid misdiagnosis and missed diagnosis.

Current VAT rules for cross-border e-commerce companies in the EU are not sustainable, because they are extremely complex and often opaque, due to the lack of tax harmonization. The aim of the research is to explore, using a qualitative method, what kind of harmonization would make the current legislation more uniform, simpler, more transparent, and easier to understand, without conflicting with the rules of any Member State. To this end, the aspects of the new platform regulation introduced on 1 July 2021 and its potential for expansion are assessed through information from possible sales models. The research suggests that the rules on platforms do not cover all possible sales models, which in our view imposes an unnecessary extra administrative burden on some businesses and makes their tax activities less transparent. In the light of the results of the research, we propose that the current EU platform regulation should be extended to cover B2B, B2C transactions and services. As a result of this suggested harmonization, a simpler, more transparent, uniform and sustainable tax system would contribute to the whitening of the economy, generating additional tax revenue for Member States.

Background and Objectives: In recent years Electronic scooters (E-Scooters) have gained popularity, whether for private use or as a publicly available transportation method. With introduction of these vehicles, reports of E-Scooter related accidents have surged, sparking a public debate and concern. Aim of this study was to analyse epidemiological data, characteristics and severity of traumatic brain injury (TBI) related to E-Scooter accidents. Materials and Methods: This retrospective case series evaluated 28 patients who were admitted to three largest neurosurgery clinics in Riga, Latvia between time period from April to October in two separate years – 2022 and 2023 after an E-Scooter related accident. Data were collected on patient demographics, time of the accident, alcohol consumption, helmet use, type of TBI, other related injuries, treatment and assessment at discharge. Results: A total of 28 patients were admitted with TBI related to E-Scooter use, with median age 30 years (Q1-Q3, 20.25-37.25), four individuals under age of 18, majority (64%) were male. In 23 cases the injury mechanism was fall, in 5 cases collision. None were wearing a helmet at time of injury. Alcohol intoxication was evident in over half of the patients (51.5%), with severe intoxication (&gt;1.2ppm) in 75% cases among them. Neurological symptoms upon admission were noted in 50% of cases. All patients had intracranial trauma - 50% brain contusions, 43% traumatic subdural hematoma, almost 30% - epidural hematoma. Craniofacial fractures were evident in 71% of cases, fractures in other parts of body in 3 patients. 6 patients required emergency neurosurgical intervention. Neurological complications were noted in 2 patients, 1 patient died. Conclusions: E-Scooter related accidents result in a significant number of brain and other associated injuries, with notable frequency linked to alcohol influence and lack of helmet use. Prevention campaigns to raise awareness of potential risks and implementation of more strict regulations should be done.

We show that Universe inflation occurs when Einstein's gravity couples to nonlinear electromagnetic fields with cosmic stochastic magnetic fields background. Nonlinear electrodynamics with two parameters is used. The strength of magnetic fields to have the Universe inflation is obtained. It is shown that singularities of the energy density and pressure are absent for any scale factors. At large scale factors one arrives at equation of state for ultra-relativistic case. It is demonstrated that the curvature invariants do not have singularities. By computing the deceleration parameter we show that graceful exit takes place with reasonable e-folding number. The duration of Universe inflation as a function of model parameters is obtained. The classical stability and causality are analyzed by calculating the speed of the sound.

In recent years, e-commerce platforms have replaced conventional marketplaces. People are rapidly adopting internet shopping due to the convenience of making purchases from the comfort of their homes. Online review sites allow customers to share their thoughts on products and services. Customers and businesses are increasingly relying on online reviews to assess and improve the quality of products. Existing literature uses Natural language processing (NLP) to analyze customer reviews for different applications. Due to the growing importance of NLP for online customer reviews, this study attempts to provide a taxonomy of NLP applications based on existing literature. This study also examined emerging methods, data sources, and research challenges by reviewing 154 publications from 2013 to 2023 that explore state-of-the-art approaches for diverse applications. Based on existing research, the taxonomy of applications divides literature into five categories: sentiment analysis, review analysis, customer feedback and satisfaction, user profiling, and marketing and reputation management. It is interesting to note that the majority of existing research relies on Amazon user reviews. Additionally, recent research has encouraged the use of advanced techniques like Bidirectional Encoder Representations from Transformers (BERT), Long Short-Term Memory (LSTM), and ensemble classifiers. The rising number of articles published each year indicates increasing interest of researchers and continued growth. This survey additionally addresses open issues, providing future directions in online customer review analysis.

Energy management systems (EMS) play a central role in improving the performance of microgrids by ensuring their efficient operation while minimizing operational costs and environmental impacts. This paper presents a comprehensive study of a MILP-based EMS developed and implemented in MATLAB using Yalmip software for the energy management of a new positive energy district in the city of Savona, Italy, as part of the Interreg Alpine Space Project ALPGRIDS. The main objective of this research is to optimize the functioning of the microgrid, focusing on cost efficiency and environmental sustainability. In pursuit of this objective, the EMS undergoes comprehensive testing and analysis, replicating actual conditions and addressing the diverse demands of end-users across typical days throughout the year considering real electricity selling and purchase price. The EMS also accounts for the reactive power capabilities of the various technologies integrated into the microgrid. The levelized cost of electricity (LCOE) serves as a metric for assessing curtailment costs, while penalties related to reactive power absorption from the distribution network are appraised in alignment with prevailing regulatory guidelines. The case study provides valuable insights into the practical implementation of EMS technology in microgrids and demonstrates its potential for sustainable energy management in complex urban energy districts. The insights and strategies developed through this research contribute to the overall goals of improving energy efficiency and reducing the environmental footprint of future energy districts.

In an era driven by technology and connectivity, where the sphere of learning goes beyond conventional classrooms, e-Service-Learning (e-SL) merges the possibilities of technology with the principles of experiential education in a powerful blend [1]. Service-learning (SL) is an educational proposal that has been cited by UNESCO [2] as an innovative educational tool through which to address the complex challenges of our society. The Sustainable Development Goals [3] provide a framework around which to structure the SL projects and thus develop the skills needed to act on the full range of goals. Embedding digital means open a debate on the intricate relationship between technology, education, and societal impact [4]. By analyzing two focus groups involving faculty, students and community partners, this contribution aims to explore the potential of combining SL and digital empowerment (DE). The focus group participants discussed the opportunities for innovation, the expected impact on them and the society at large, their needs and the pre-conditions needed to make SL and DE successful, and limitations. The results are presented according to the six principles of sustainability education in the university environment, highlighting the transformative potential of combining these principles within SL and DE.

The rapid advancement of technology has led to increased electronic consumption and a corresponding rise in e-waste generation. To address this issue, this study develops a low-carbon e-commerce closed-loop supply chain (LCE-CLSC) system with remanufacturer, platform, and the government as key stakeholders. An evolutionary game approach is employed to investigate the system's dynamics, analyzing the impact of stakeholder strategies on system equilibrium. Numerical simulations reveal important findings: Firstly, government initiatives promoting recycling, carbon taxes on traditional products, can incentivize remanufacturers to produce low-carbon items and encourage platform investment in recycling services. Secondly, higher sales revenues motivate remanufacturers to produce low-carbon products. Thirdly, consumer sensitivity to recycling services strengthens waste recovery when platforms increase investments in these services, leading to remanufacturers choosing low-carbon production. Lastly, government subsidies may become ineffective if the cost of remanufacturers' carbon reduction and platforms' recycling services exceeds their affordability. These findings offer insights for the sustainable development of obsolete electronic product recycling systems.

Sporadic Alzheimer’s disease (AD) derives from an interplay among environmental factors and genetic variants, while epigenetic modifications have been expected to affect the onset and progression of its complex etiopathology. Heterozygous carriers of the apolipoprotein E gene (APOE)4 allele have a 4-fold increased risk of developing AD, while APOE 4/4-carriers have a 12-fold increased risk in comparison with the APOE 3-carriers. The main longevity factor is the homozygous APOE ε3/ε3 genotype. In the present narrative review article, we summarized and described the role of APOE epigenetics in aging and AD pathophysiology. It is not fully understood how APOE variants may increase or decrease AD risk, but this gene is known to affect amyloid- and tau-mediated neurodegeneration directly or indirectly, also by affecting lipid metabolism and inflammation. For sporadic AD, epigenetic regulatory mechanisms may control and influence APOE expression in response to external insults. Diet, a major environmental factor, has been significant associated with physical exercise, cognitive function, and the methylation level of several cytosine-phosphate-guanine (CpG) dinucleotides sites of APOE.

Urinary tract infections (UTIs) caused by pathogens, particularly E. coli, have spontaneously become resistant to antimicrobial drugs in recent years. Therefore, regular monitoring and alternative strategies for the antimicrobial agent are crucial for combating antimicrobial resistance and bacterial biofilms. Here, we report a new cobalt iron oxide-conjugated tin oxide nanocomposite that can kill bacteria and treat multidrug-resistant E. coli posing UTIs. Following the isolation and identification of E. coli, we tested 57/134 samples against sixteen commonly used antibiotics phenotypically using the disk diffusion method to determine their sensitivity pattern. Of the 57 E. coli isolates, 66% (38/57) were multidrug-resistant. The E. coli isolates were resistant to cephradine (70.17%), ceftriaxone (59.64%), and azithromycin (59.64%), followed by cefixime (54.38%), cefuroxime sodium (52.63%), and co-trimoxazole (50.87%). X-ray diffraction results showed the crystallite sizes were about 5.68 and 8.84 nm in pure SnO2 nanoparticles and 95% SnO2-5% CoFe2O4 nanocomposite, respectively. Energy-dispersive X-ray spectroscopy and Fourier transform infrared determined the fundamental structure of the nanocomposite, encompassing Co, Fe, Sn, and O. Moreover, FTIR measurements implied that the distinct functional groups in both SnO2 and CoFe2O4 nanoparticles existed in a 95% SnO2-5% CoFe2O4 nanocomposite. Field emission scanning electron microscope analysis uncovered that the SnO2-CoFe2O4 nanocomposite had a size of roughly 24 nm and was spherical. In addition, the biosynthesized SnO2 nanoparticles and SnO2-CoFe2O4 nanocomposite were evaluated for their antibacterial activity. At a minimum 100 µg/mL concentration, SnO2 nanoparticles and SnO2-CoFe2O4 nanocomposite showed high antibacterial activity. The SnO2 nanoparticles and SnO2-CoFe2O4 nanocomposite demonstrated antibacterial activity on multidrug-resistant E. coli at 10 ± 0.7 and 16 ± 0.8 mm zone of inhibition, respectively. In conclusion, the new SnO2-CoFe2O4 nanocomposite might be a potential candidate for treating UTIs caused by drug-resistant E. coli in the foreseeable future.

A new power receiving unit (PRU) is proposed in this paper for the resonant wireless power transfer (WPT), which is characterized by the capability of attracting high power from the power transmitting unit (PTU). The resonant WPT is designed for delivering the electrical power to the PRU attached on an electrical vehicle (EV) chassis 50cm away from a PTU installed on the ground. The proposed PRU uses only the passive elements such as inductors, diodes and the capacitors, which needs no initial power from the EV. It is then applicable for charging a battery to several hundred volts for even a first-time charging battery. At a switching frequency of the resonant WPT in the experiment being 4MHz, the proposed PRU behaves itself as a negative impedance converter (NIC) in the subharmonics of 4MHz. The NIC effect plus the subharmonic oscillation causes an instability current charging the battery connected to the PRU. In this paper, we simulated the PRU and performed the experiment. The experiment demonstrates a battery charging of 150W from 50cm away using three D-mode GaN HEMT transistors via the instability current ramp. The power transfer efficiency (PTE) improved as the power delivered to load (PDL) goes higher. The best power transfer efficiency (PTE) is 65% in the present findings. The simulation analysis shows that the circuit allows itself be used to much higher power transfer when it is implemented with more GaN HEMT transistors connected in parallel. The theoretical derivation of the PRU circuit is also used to support both the experimental and simulation results.

Many studies have been conducted using pectin for modified drug delivery. In this regard, the goal of the work was to obtain interpolyelectrolyte complexes based on citrus or apple pectin and the Eudragit® EPO and study properties from the standpoint of using these carriers for oral drug delivery. Turbidity, gravimetry, viscosity, elementary analysis and FTIR spectroscopy, DSC analysis were used for physicochemical characterization. Diffusion-transport characteristics were studied to assess the swelling ability of the matrices and the release of diclofenac sodium. Mathematical modeling of the release parameters was carried out using the Krosmayer-Peppas equation. During the turbidity study, stoichiometry compositions were selected for the studied IPECs EPO/PeсA and EPO/PeсC at pH values = 4.0, 5.0, 6.0, 7.0. FTIR spectra of the complexes are characterized by an increase in the intensity of the bands at 1610 cm-1 and 1400 cm-1. According to the DSC analysis IPEC has a certain Tg = 57.3°C. The highest release rates are shown by IPEC EPO/PecC_1 and EPO/PecC_4. The mechanism of drug transport from the matrices IPEC EPO/PecC, IPEC EPO/PecA_3 and EPO/PecA_4 can be characterized as Super Case II. Anomalous (non-Fickian release) is typical for IPEC EPO/PecA_1 and EPO/PecA_2. Thus, the resulting systems are suitable for colon-specific drug delivery systems.

A 4×2 factorial experiment was conducted to evaluate the potential of feeding dietary gamma-oryzanol and vitamin E tocotrienols in hens reared in 840 (low cage density; LCD) or 420 cm2/hen (high cage density; HCD). A total of 120 hens were allocated into eight groups with five replicates. Diets were a control (CON) or the control diet supplemented with 200 ppm gamma-oryzanol (GO-200), 200 ppm vitamin E tocotrienols (VE-200) or 200 ppm gamma-oryzanol + 200 ppm vitamin E tocotrienols (GE-400). Results showed that HCD-housed hens decreased (P &lt; 0.01) egg performance and quality. Average egg weight (AEW), egg mass and FCR improved in all supplemented treatments. Results on the AEW, FCR, and eggshell qualities of birds kept at the HCD revealed the best responses in the GE-400 group (P &lt; 0.01). Among hens kept on an HCD, there was a noticeable decrease in HMGCR mRNA abundance in the VE-200 group, while the highest IFN-γ mRNA abundance was found in hens fed the GO-200 diet (P &lt; 0.05). Thus, this study suggested that dietary GO or VE at 200 ppm either individually or in combination could improve performance and egg quality as well as regulate the abundance of immune- and stress-related genes.

Taiwan’s Chi Mei Medical Center has a vision of becoming a sustainable organization. They found they violated the sustainable development goal (SDG) 13 (“Climate Action”) since its workflows consume excessive tangible resources and waste much operation time. To fulfill the vision, the Chi Mei Medical Center first introduced electronic invoicing. Implementing this electronic invoicing included adopting cloud E-invoice data and creating a software robot for auditing them. This study presents this software robot and its contributions. The software robot replaces an internal auditor to log into Taiwan’s E-invoice platform, download cloud E-invoice data, and detect the inconsistency between these cloud and on-premise data. Internal auditors of the Chi Mei Medical Center only needed to confirm the detection results. They welcome this software robot since it significantly reduces their work burdens. They approved more software robots for assisting other workflows. Besides, the Chi Mei Medical Center earned profits after eliminating paper invoices. This elimination helped release less carbon. This study concludes that chasing a sustainable organization is unnecessarily equivalent to the requirement of more costs. A software robot represents the last puzzle for constructing a paperless workflow since it can resolve the resistance of existing workers to a new workflow.

E-commerce recommendation systems usually deal with massive customer sequential databases, such as historical purchase or click stream sequences. Recommendation systems’ accuracy can be improved if complex sequential patterns of user purchase behavior are learned by integrating sequential patterns of customer clicks and/or purchases into the user-item rating matrix input of collaborative filtering. This reviews focuses on algorithmic techniques of existing E-commerce recommendation systems that are sequential pattern based such as ChoRec05, ChenRec09, HuangRec09, LiuRec09, ChoiRec12, Hybrid Model RecSys16, Product RecSys16, SainiRec17, HPCRec18 and HSPCRec19. It provides a comprehensive and comparative performance analysis of these systems, exposing their methodologies, achievements, limitations, and potentials for solving more important problems in this domain. The review showed that integrating sequential pattern mining of historical purchase and/or click sequences into user-item matrix for collaborative filtering (i) improved recommendation accuracy (ii) reduced user-item rating data sparsity (iii) increased novelty rate of recommendations and (iv) improved scalability of the recommendation system.

The objective of the present study is to isolate phages targeting multidrug resistant (MDR), extended spectrum beta lactamase (ESBL) positive clinical isolate of E. coli ( U1007), sequence and analyze the phage genome and use machine learning tools to predict host cell surface receptor and finally evaluate the efficiency of monophage and phage cocktail in vitro and in vivo in a zebrafish model. Phage specific for E. coli U1007 was isolated from Ganges River (designated as U1G), Cuoom River (designated as CR) and Hospital waste water (designated as M phage). The obtained phages were triple purified and enriched. U1G phages had a greater burst size of 124 PFU/cell and a latent time of 25 min.M phage had a burst size of 150 PFU/cell with a shortlatent time of 20min. Similarly CR phage has a short latent 20 min and a burst size of 115 PFU/cell. Based on capsid architecture, U1G phage resembles Podoviridae, CR phage is structurally similar to Myoviridae and M phage has morphology that resembles Siphoviridae. Genome sequencing and analysis revealed that the size of the U1G phage genome is 73275 bp Whereas that of CR phage and M phage are 45236 bp and 45294 bp, respectively. All three genomes were marked by the absence of genes encoding tRNA sequence, antibiotic resistant or virulent genes. A machine learning (ML) based multi-class classification model using algorithms such as Random Forest, Logistic Regression, and Decision Tree were employed to predict the host receptor targeted by all 3 phages and the best performing algorithm Random Forest predicted LPS O antigen , LamB or OmpC for U1G FhuA, OmpC for CR phage and FhuA, LamB, TonB or OmpF for the M phage as the host receptor targeted by the receptor binding protein (RBP) of the phages. In vitro time kill assay showed that treatment with monophages alone and along with colistin resulted in regrowth whereas phage combinations significantly reduced the regrowth and by 24h the phage cocktail along with colistin produced a significant 3 log declinein cell counts relative to the untreated control. In vivo intramuscular infection study in zebrafish showed that phages were non toxic and a cocktail of dual (U1G +M) phage along with colsitin resulted in a significant 3.5 log decline in cell counts whereas triple phage combination along with colistin resulted in 3 log decline in cell counts probably due to host receptor competition. Our study highlights the potential of phage cocktail therapy in mitigating MDR clinical isolate of E. coli in vitro and in vivo.

Numerous goods and services are now offered through online platforms due to the recent growth of online transactions like e-commerce. Users have trouble locating the product that best suits them from the numerous products available in online shopping. Many studies in deep learning-based recommender systems (RSs) have focused on the intricate relationships between the attributes of users and items. Deep learning techniques have used consumer or item-related traits to improve the quality of personalized recommender systems in many areas, such as tourism, news, and e-commerce. Various companies, primarily e-commerce, utilize sentiment analysis to enhance product quality and effectively navigate today's business environment. Customer feedback regarding a product is gathered through sentiment analysis, which uses contextual data to split it into separate polarities. The explosive rise of the e-commerce industry has resulted in a large body of literature on e-commerce from different perspectives. Researchers have made an effort to categorize the recommended future possibilities for e-commerce study as the field has grown. There are several challenges in e-commerce, such as fake reviews, frequency of user reviews, advertisement click fraud, and code-mixing. In this review, we introduce an overview of the preliminary design for e-commerce. Second, the concept of deep learning, e-commerce, and sentiment analysis are discussed. Third, we represent different versions of the commercial dataset. Finally, we explain various difficulties facing RS and future research directions.

Background: Expansion of OKF6/TERT-2 oral epithelial cells in vitro is important for studying the molecular biology of disease and pathology affecting the oral cavity. Keratinocyte Serum-Free Medium (KSFM) is the medium of choice for this cell line. This study compares three media for OKF6/TERT-2 cultures: KSFM, Dulbecco’s Modified Eagle Medium/Nutrient Mixture of Hams F-12 (DMEM/F12) and a composite medium comprised of DMEM/F-12 and KSFM (1:1 v/v), referred as DFK. The toxicological effects of electronic cigarette liquids (E-liquids) on OKF6/TERT-2 cells cultured in these media were also compared. Methods: Cells were cultured in KSFM, DMEM/F12 or DFK and cellular morphology, growth, wound healing and gene expression of mucins and tight junctions were evaluated. Additionally, cytotoxicity was determined after E-liquid exposures. Results: Switching from KSFM to DMEM/F12 or DFK 24-hours post-seeding leads to typical cellular morphologies, and these cultures reach confluency faster than those in KSFM. Wound-healing recovery occurred fastest in DFK. Except for claudin-1, there is no difference in expression of the other genes tested. Additionally, E-liquid cytotoxicity appears to be amplified in DFK cultures. Conclusions: DMEM/F12 and DFK are alternative media for OKF6/TERT-2 cell culture to study molecular biology of disease and pathology, provided cells are initially seeded in KSFM.

This review paper delves into using micro-credentials in higher education ecosystems as a digital enablers. Micro-credentials, which are digital credentials that attest to a learner’s mastery of a specific skill or knowledge area, are becoming more popular in higher education. The paper examines the successful implementation of micro-credential frameworks in higher education, using case studies to demonstrate the advantages of micro-credentials. The review emphasizes the agility and flexibility of microcredentials, which enable learners to acquire new skills quickly and respond to changes in the job market. In addition, the paper discusses the digital nature of micro-credentials and how they allow institutionsto provide targeted, skills-based training that isrelevant to employers. It also explores how micro-credentials are delivered through online platforms, making them convenient and easily accessible for learners. The review underscores the significance of digital infrastructure, connectivity, and public utility for promoting micro-credentials. The paper argues that micro-credentials function as a digital enabler for higher edu- cation ecosystems, allowing learners to acquire targeted training and enabling institutions to expand their offerings and reach more students. The paper concludes by highlighting the potential for micro-credentials to help bridge the skills gap and equip learners with the skills necessary to succeed in today’s digital economy.

The use of Learning Management Systems (LMS) has had a rapid growth over the last decades. Great efforts have been recently made to assess the level of performance of the students online due to the COVID-19 pandemic. Faculty members with limited experience in the use of LMS such as Moodle, Edmodo, MOOC, Blackboard and Google Classroom can have some problems creat-ing online tests. In this work, a new plugin for Moodle is presented: FastTest PlugIn. This plugin is based on a Microsoft® Excel spreadsheet and it can be used to export questions to Moodle. Us-ers of FastTest PlugIn can create question pools in an easy and intuitive way. A literature review about plugins used to import/export questions in Moodle is carried out. Then, the characteristics of FastTest PlugIn are presented. At the end, the characteristics of the main plugins found in the literature are discussed and compared with the ones of FastTest PlugIn.

The global pandemic caused by the new coronavirus has largely changed established business practices. The aim of the study is to present the results of eighteen-month intensive research into the effects of the pandemic on e-consumer behavior. In one of the most active e-commerce markets in Europe, the Czech Republic, we analyzed a sample of more than one and a half million Facebook users in terms of their C2B interactions on the B2C activities of the five major e-commerce market players. The measurements were carried out in three periods, which corresponded to the onset of the first wave, peak, and fading of the second wave of the pandemic. This enabled us to monitor the effect of seasonality and the stabilization of patterns of consumer behavior during the coronavirus crisis. The results suggest that a specific panic pattern of e-consumer behavior was developed at the time of the onset of the pandemic. However, as the pandemic progressed, the market has adapted to a new normal, which, as evidenced by the change in trends, appears to be a combination of the pre-pandemic and pandemic behavioral patterns. Using a statistical analysis, it was possible to identify delta of changes within the patterns of consumer behavior, thus fulfilling the final condition for creating an empirical model of the COVID-19 pandemic impacts on e-consumer behavior presented in this study.

Background: Serious games are conceptualized as a broad topic and overlap segments of more modern forms of education: e-learning, edutainment, game-based learning, and digital game-based learning. Serious Games aligns with digitalization and the modern era and creates novel opportunities for learning and assessment in medical education. Escape rooms, a type of serious games, merge mental and physical aspects to reinforce critical skills useful in daily life. It challenges logic and reasoning and demands careful analysis of situations to correlate and solve different stages of the escape room under pressurized, timed conditions. Furthermore, it serves as an adequate environment to build problem-solving skills, communication skills, and leadership skills through the collaboration of people to achieve a common goal. The aim of this study was to investigate the applications of escape rooms in Medical Education. Method: This study investigated the applications of escape rooms in medical education. Serious games are expanding in education and have attained great relevance due to their intriguing and intrinsically motivating attributes. Within serious games, we focused on escape rooms in which participants are locked in a room, faced with puzzles that must be solved to ‘escape the room’. Compiling the data from the first 100 hits of medical application of escape rooms, we found 72 cases and categorized them by year, specialty, participants structure, simulation experience, and design. Results: We reported on escape rooms in medical education by the year in which they were reported, the medical specialty, the participant structure, grouped or individual, the experience design; real, hybrid, or digital, and the modality of the delivery. 72% of the escape rooms focused on four main areas: nursing education (25.0%), emergency medicine (22.2%), pharmacy (12.5%), and interprofessional education (12.5%). Most of the escape rooms had a group-based physical design and little attention was given to provide a detailed description of the design considerations, such as the pathway type (linear, semi-linear, open). Conclusion: Escape rooms are applied in a wide range of medical education areas. In Medical Education, group-based on-site escape rooms with a focus on nursing, emergency medicine, pharmacy and interprofessional education dominates the implementation landscape. To further advance the field, stronger emphasis on making explicit the design considerations will advance the research and inform implementations.

The adverse relationship between viral hepatitis and pregnancy in developing countries was seen as a reflection of retrospective biased hospital-based data collection by the West. However, the discovery of HEV from an epidemic of non-A, non-B hepatitis in Kashmir and documenting increased incidence and severity of hepatitis E in pregnancy from a house-to-house survey unmasked the unholy alliance. Among the family of HEV’s, genotype (gt)-1, with a unique ORF4-encoded protein enhancing viral polymerase activity and viral replication, is the sole HEV that shows this adverse relationship. The epidemics caused by HEV-gt1 and not by HEV-gt2 show adverse relationship with pregnancy. The pathogenesis of the unholy alliance is complex and at present not well understood. Possibly multiple factors play a role in causing severe liver disease in the mother including: infection, replication and damage to the maternal-foetal interface by HEV-gt1; vertical transmission of HEV to foetus causing severe foetal/neonatal hepatitis; and combined viral and hormone related immune dysfunction of diverse nature in the mother promoting viral replication. Management is multidisciplinary and needs a close watch for the development and management of ALF. Preliminary data suggest beneficial maternal outcomes by early termination of pregnancy in patients with lower grades of encephalopathy.

DDX3 is an ATP-dependent RNA helicase involved in multiple cellular activities, including RNA metabolism and innate immunity. DDX3 is known to assist the replication of some viruses while restricting some others through direct interaction with the viral proteins. However, the role of DDX3 in the replication of the hepatitis E virus (HEV) is unknown. In this study, DDX3 is shown to interact with the HEV capsid protein and provide an indispensable role in HEV replication. The DDX3 C-terminal domain was demonstrated to interact with the capsid protein, which was previously demonstrated to inhibit the production of type I interferons. Knockdown of DDX3 compromised the capsid protein-mediated blockage of interferon induction. Notably, DDX3 silencing led to a significant reduction in HEV replication. Also, the ATPase activity of DDX3 is required for the HEV replication as an ATPase-null mutant DDX3 failed to rescue the viral replication in the DDX3-silenced cells. These results demonstrate a pro-viral role of DDX3 in HEV replication, providing further insights into the virus-cell interactions.

Mast cells are long-lived, granular, myeloid-derived leukocytes that have significant protective and repair functions in tissues. Mast cells sense disruptions in the local microenvironment and are first responders to physical, chemical and biological insults. When activated, mast cells release growth factors, proteases, chemotactic proteins and cytokines thereby mobilizing and amplifying the innate and adaptive immune system. Mast cells are therefore significant regulators of homeostatic functions and may be essential in microenvironmental changes during pathogen invasion and disease. During infection by helminths, bacteria and viruses, mast cells release antimicrobial factors to facilitate pathogen expulsion and eradication. Mast cell-derived proteases and growth factors protect tissues from insect/snake bites and exposure to ultraviolet radiation. Finally, mast cells release mediators that promote wound healing in the inflammatory, proliferative and remodeling stages. Since mast cells have such a powerful repertoire of functions, targeting mast cells may be an effective new strategy for immunotherapy of disease and design of novel vaccine adjuvants. In this review, we will examine how certain strategies that specifically target and activate mast cells can be used to treat and resolve infections, augment vaccines and heal wounds. Although these strategies may be protective in certain circumstances, mast cells activation may be deleterious if not carefully controlled and any therapeutic strategy using mast cell activators must be carefully explored.

The implementation of teaching interventions in learning needs has received considerable attention, as the provision of the same educational conditions to all students, is pedagogically ineffective. In contrast, more effectively considered the pedagogical strategies that adapt to the real individual skills of the students. An important innovation in this direction is the Adaptive Educational Systems (AES) that support automatic modeling study and adjust the teaching content on educational needs and students' skills. Effective utilization of these educational approaches can be enhanced with Artificial Intelligence (AI) technologies in order to the substantive content of the web acquires structure and the published information is perceived by the search engines. This study proposes a novel Adaptive Educational eLearning System (AEeLS) that has the capacity to gather and analyze data from learning repositories and to adapt these to the educational curriculum according to the student skills and experience. It is a novel hybrid machine learning system that combines a Semi-Supervised Classification method for ontology matching and a Recommendation Mechanism that uses a hybrid method from neighborhood-based collaborative and content-based filtering techniques, in order to provide a personalized educational environment for each student.

Biofilms enable the persistence of pathogens in food processing environments. In order to inactivate these microorganisms, sanitizing agents are needed that are effective against pathogens entrapped in biofilms which are more difficult to inactivate than planktonic cells that are displaced and found on equipment surfaces. We examined conditions to develop, analyze, and enumerate robust biofilms of 3 different foodborne pathogens assisted by fluorescence adherence assay and enzymatic detachment. We compared 3 different isomeric forms of fluorescent substrates that are readily taken up by bacterial cells based on carboxy-fluorescein diacetate (5-CFDA, 5,6-CFDA, 5,6-CFDA,SE). Biofilm-forming strains of L. monocytogenes, E.coli O157:H7, and Salmonella serovars were detected using the chosen substrate in a microplate fluorescence assay define previously for use with Listeria. Adherence levels were determined by differences in relative fluorescence units (RFU). Multiple hydrolytic enzymes were examined for each representative pathogen for the most suitable enzyme for detachment and enumeration to confirm data obtained by fluorescence assay. Cultures were grown overnight in microplates, incubated, washed and replenished with fresh sterile growth medium; this cycle was repeated 7 times before used as ‘biofilms’. All treatments were performed in triplicate and compared by one-way analysis of variance (ANOVA) to determine significant differences (p < 0.05). Analysis of 7-day biofilms by SEM indicated possible extracellular polysaccharide involvement with Salmonella and E. coli.

Here, we propose a novel scheme based on advanced techniques of digital modulation in optical communications to achieve a single-channel transmission rate above 100 Gb/s. We utilize a hybrid scheme amplitude/phase/frequency/dual polarization, combined with multidimensional dual lattice and a low-density parity-check-coded modulation. The Stokes parameters are applied to the proposed scheme to map the four-dimensional classical polarization \({I_X},{Q_X},{I_Y},{Q_Y}\) in a three-dimensional space. In addition, in the proposed system, the packing theory is applied to the bit interleaver process, three wavelengths are packaged before being transmitted over a wavelength-division multiplexing optical channel. This modulation process is carried out using symmetrical geometric shapes, such as a hypercube or a polyhedron, based on the molecular links theory using a grouping of 12 and 13/15 bits for the cubic and spherical lattices, respectively. The proposed technique is evaluated in the context of long distance communications over distances up to 100 km. The bit error rate results showed that the optical signal-to-noise ratio was approximately 4 dB over a distance of 50 km. In addition, the power spectral efficiency was found to be 3 lambda, which is considered good performance considering the effects of distance and the non-linear effects influencing the number of lambdas. Also, we use an optical time division multiplexing scheme (OTDM) in order to achieve a transmission rate beyond 1Tbit/s, where the speed effect is evaluated, taking into consideration that the power spectral efficiency is degraded. Furthermore, the average noise floor is -60dBm for all transmission distances. These findings are expected to contribute to the future implementation of robust long-distance optical communication infrastructure.

Traditionally understood in reference to distance education, cognitive presence may be defined as "the extent to which the participants in any particular configuration of a community of inquiry can construct meaning through sustained communication. The purpose of this paper was to create a blueprint for the reflective ePortfolio as the capstone project for my graduate degree. The blueprint was accomplished by adapting for use cognitive presence as a tool for both analysis and framing, which has never been done to the best of my knowledge. I considered myself to be a participant in a “community of inquiry” model and substituted the result of my interaction with each of the required instructor-course content pairings I took to serve as fellow participants in this community model. The result of my participation was understood to be the knowledge and experience that I have gained, which was reflected in eight of my academic research papers. These selected papers were the artifacts around which my ePortfolio was ultimately developed and demonstrated my participation as an active member in this community of inquiry constructing meaning through sustained communication.

The geometry of Poincare disk itself is interpreted without any mapping to dierent spaces. Our approach might be one of the shortest and is intended for educational contribution.

Hydrological models have been widely used for many purposes in water sector projects, including streamflow prediction and flood risk assessment. Among the input data used in such hydrological models, the spatial-temporal variability of rainfall datasets has a significant role on the final discharge estimation. Therefore, accurate measurements of rainfall are vital. On the other hand, ground-based measurement networks, mainly in developing countries, are either nonexistent or too sparse to capture rainfall accurately. In addition to in-situ rainfall datasets, satellite-derived rainfall products are nowadays available globally with high spatial and temporal resolution. An innovative approach called SM2RAIN that estimates rainfall from soil moisture data has been applied successfully to various regions. In this study, firstly soil moisture content derived from the Advanced Microwave Scanning Radiometer for the Earth observing system (AMSR-E) is used as input into the SM2RAIN algorithm to estimate daily rainfall, SM2R-AMSRE, at different sites in the Karkheh river basin (KRB), southwest Iran. Secondly, the SWAT (Soil and Water Assessment Tool) hydrological model is applied to simulate runoff using both ground-based observed rainfall and SM2R-AMSRE rainfall as input. The results reveal that the SM2R-AMSRE rainfall data are, in most cases, in good agreement with ground-based rainfall, with correlations R ranging between 0.58 and 0.88, though there is some underestimation of the observed rainfall, due to soil moisture saturation, not accounted for in the SM2RAIN equation. The subsequent SM2R-AMSRE- SWAT- simulated monthly runoff reproduces well the observations at the 6 gauging stations (with coefficient of determination, R² > 0.72), though with slightly worse performances in terms of bias (Bias) and root-mean-square error (RMSE) and, again, some systematic flow underestimation than the SWAT model with ground-based rainfall input. Furthermore, rainfall estimations of two satellite products of the Tropical Rainfall Measuring Mission (TRMM), 3B42 and 3B42RT, are used in the calibrated SWAT- model. The monthly runoff obtained with 3B42- rainfall have 0.39< R2 < 0.70 and are slightly better than those obtained with 3B42RT- rainfall, but not as good as the SM2R-AMSRE- SWAT- simulated runoff above. Therefore, in spite of the afore-mentioned limitations, using SM2R-AMSRE rainfall data in a hydrological model like SWAT, appears to be a viable approach in basins with limited ground-based rainfall data.

The Medi-test system we developed was motivated by the large number of resources available for the medical domain, as well as the number of tests needed in this field (during and after the medical school) for evaluation, promotion, certification, etc. Generating questions to support learning and user interactivity has been an interesting and dynamic topic in NLP since the availability of e-book curricula and e-learning platforms. Current e-learning platforms offer increased support for student evaluation, with an emphasis in exploiting automation in both test generation and evaluation. In this context, our system is able to evaluate a student’s academic performance for the medical domain. Using as input medical reference texts and supported by a specially designed medical ontology, Medi-test generates different types of questionnaires for Romanian language. The evaluation includes 4 types of questions (multiple-choice, fill in the blanks, true/false and match), can have customizable length and difficulty and can be automatically graded. A recent extension of our system also allows for the generation of tests which include images. We evaluated our system with a local testing team, but also with a set of medicine students, and user satisfaction questionnaires showed that the system can be used to enhance learning.

Educational data-mining is an evolving discipline that focuses on the improvement of self-learning and adaptive methods. It is used for finding hidden patterns or intrinsic structures of educational data. In the arena of education, the heterogeneous data is involved and continuously growing in the paradigm of big-data. To extract meaningful information adaptively from big educational data, some specific data mining techniques are needed. This paper presents a clustering approach to partition students into different groups or clusters based on their learning behavior. Furthermore, personalized e-learning system architecture is also presented which detects and responds teaching contents according to the students’ learning capabilities. The primary objective includes the discovery of optimal settings, in which learners can improve their learning capabilities. Moreover, the administration can find essential hidden patterns to bring the effective reforms in the existing system. The clustering methods K-Means, K-Medoids, Density-based Spatial Clustering of Applications with Noise, Agglomerative Hierarchical Cluster Tree and Clustering by Fast Search and Finding of Density Peaks via Heat Diffusion (CFSFDP-HD) are analyzed using educational data mining. It is observed that more robust results can be achieved by the replacement of existing methods with CFSFDP-HD. The data mining techniques are equally effective to analyze the big data to make education systems vigorous.

People from Black and Asian backgrounds are more likely to die from Covid-19 but less likely to be vaccinated, threatening to exacerbate health inequalities already experienced by ethnic minority groups. Literature suggests that mistrust rooted in structural inequality may be a key barrier to Covid-19 vaccine uptake. We need to better understand how structural inequalities influence vaccine confidence. Understanding and addressing these processes is likely to lead to longer-term impacts than information alone. We draw on health and sociological theories of structure and agency to inform our understanding of structural factors. We conducted qualitative interviews and focus groups with 22 people from London and surrounding areas in December 2021 to March 2022. Fifteen participants were members of the public from ethnic minority backgrounds and 7 were professionals working with the public to address concerns and encourage vaccine uptake. Our findings suggest that people from ethnic minority backgrounds make decisions regarding Covid-19 vaccination based on a combination of how they experience external social structures (including political authority, social positioning and racial inequality) and internal processes (what they believe and understand about Covid-19 vaccines). We may be able to support knowledge accumulation through the provision of reliable and accessible information, particularly through primary and community care. But we recommend a number of changes to research, policy and practice which address structural inequalities. These include working with communities to improve ethnicity data collection, increasing funding allocation to health conditions where ethnic minority communities experience poorer outcomes, greater transparency and public engagement in the vaccine development process, and culturally adapted research recruitment processes.

Health services play an important role in people's lives and are the basic right of every individual. Equal and quality access to health services is crucial for people's welfare. This study aims to analyze the effectiveness of public service innovation in achieving 100% UHC in Semarang City, with a focus on PANGERAN DIPONEGORO’s inspirational contribution, in order to provide insight regarding the implementation of the health insurance program and its impact on UHC. The method used in this research is qualitative using the Double Diamond approach with primary data collection through documentation and innovation supporting literature studies and secondary data collection through literature studies and Focus Group Discussions. The results of the study show that the "PANGERAN DIPONEGORO" innovation succeeded in having a significant positive impact in achieving Universal Health Coverage (UHC) in Semarang City. There has been an increase in community participation, accessibility and quality of health services, as well as a competitive advantage that is rarely possessed by other agencies. There have been many studies using public service objects. However, little has been discussed about the contribution and innovation of public services, especially those that focus on the health sector.

In the United States, obesity is prevalent, and it could be described as a pandemic. Obesity is excessive fat accumulation, leading to a BMI ≥ 30 (Fruh, 2017). Surveys conducted by the CDC show that the obesity prevalence in the US is on the rise, as several obese people rose from 30.5% to 41.9% between 1999 and 2020 (Bryan et al., 2021). During the same time, several people suffering from severe obesity rose from 4.7% to 9.2% (Bryan et al., 2021). Additionally, childhood obesity is on the rise. Statistics indicate that between 2017-2020 over 19.7% of children and adolescents aged 2-19 years had obesity. During the same period, obesity prevalence in children aged 2-5 years, 6-11 years, and 12-19 years olds was 12.7%, 20.7%, and 22.2%, respectively (Bryan et al., 2021). With so many people suffering from obesity, the WHO declared it a public health crisis (WHO, 2020). The COVID-19 pandemic further exacerbated the prevalence of obesity in the US. According to the surveys, there was a 4.4% increase in obesity between 2019 to March 2020 due to lifestyle changes that were put on people during the COVID-19 pandemic (Akter et al., 2022). Many comorbidities are associated with obesity. Without adequate health interventions, millions of people could suffer severe health disorders like respiratory problems, type II diabetes, psychological issues, gastrointestinal disorders, and cardiovascular diseases. It is also essential to develop health interventions to mitigate obesity due to its strain on the healthcare system. Research shows that people suffering from obesity spend $2,505 more than people with average weight on healthcare (Cawley et al., 2021). Obesity has financial ramifications in every healthcare category: inpatient, outpatient, and prescription drugs (Cawley et al., 2021). One essential action toward the efforts to mitigate the soaring obesity rates is understanding the demographic inequities across populations and how they can be resolved.

Under the dual background of underemployment and health inequality, this paper empirically analyzes the impact of education level on underemployed workers’ health based on CLDS2016 data. The results show that underemployment is significantly related to the decline of self-rated health, increased depression tendency, and morbidity in a certain period. The results indicate that underemployment can significantly reduce the health level of workers in the low education level group and the high education level group. However, it has no significant impact on workers’ health in the middle education level group; even if we change the measurement method of indicators and consider endogeneity, the research conclusion is still robust. Moreover, this kind of health inequality mainly comes from the difference in economic effect and leisure effect of underemployment to workers with different educational levels. This paper provides empirical support for increasing the labor protection mechanism of underemployed people and reducing the health inequality caused by educational level differences.

Objective: ISPOR is the leading professional society for health economics and outcomes research (HEOR) globally. Recently, it launched its Women in HEOR Initiative, that aims to serve as a catalyst for women’s leadership in the field. Therefore, we were interested to find out how well ISPOR itself is doing in terms of gender diversity at their biggest conference. Methods: We used the conference programmes of ISPOR Europe conferences in 2016, 2017 and 2018 to assess the gender distribution of speakers that participated in issue panels and plenary sessions in these years. Results: 70% of all speakers (N=346) at 85 issue panels and plenary sessions during 2016, 2017, and 2018 were male. Almost one in three panels was all-male (a ‘manel’) and 64% of all panels had mostly male speakers (>50%). In contrast, only 11% of panels had <50% female speakers. Conclusion: Despite laudable effort to support the growth, development and contribution of women in HEOR through its Women in HEOR Initiative, females appear to be severely underrepresented at ISPOR’s biggest conference. ISPOR should make gender diversity a formal requirement for issue panel abstract submissions if it wants to advance women’s leadership in HEOR.

Background: Historically, in the United States and globally, women have supported other women before, during, and after childbirth. Birth doulas are considered an important component to eliminating racial disparities in maternal morbidity and mortality. To address disparities in birth outcomes, Healthy Women Healthy Futures (HWHF) provides free birth and postpartum doula services to low-income women and communities of color in New York City. Methods: Secondary analysis of program data (n=364) collected between 2020 and 2021 was conducted. Univariate and multivariable analyses focused on: method of delivery, preterm birth, low-birthweight birth, breastfeeding, maternal-infant skin contact. The key exposure variable was total doula hours. Results: Clients who received prenatal doula support had low rates of preterm birth (8.8%) and low birthweight (7.1%), and high rates of vaginal delivery (69.1%), breastfeeding in the hospital (90.9%), and maternal-infant skin contact (78.2%). Multivariable analysis did not identify an association between number of doula hours and any of the five outcomes examined. Conclusion: While descriptive results point to positive birth outcomes, these effects did not persist in multivariable analyses. Data quality concerns from this intervention likely hindered the ability to detect a program impact, emphasizing the importance of funding to support data collection and management activities.

Background: This study aimed to explore the association between the emotional impact of COVID-19 and emotional eating and the risk of alcohol use disorder among Peruvian health science students. Methods: We conducted a cross-sectional analytical study in which an online questionnaire was administered to 456 health science interns from four cities in Peru. We used the COVID-19 Emotional Impact Profile questionnaire, Mindful Eating Questionnaire, and Alcohol Use Disorders Identification Test. Spearman’s correlations were calculated and two multiple linear regression models were developed. Results: 68.4% of the participants were emotional eaters and 8.6% reported low-risk levels of alcohol use disorder. Based on the results of the first model, the overall emotional impact of COVID-19, being overweight or obese, depression and anxiety levels, and living with only one parent were factors associated with emotional eating. The results of the second model showed that the level of depression, living with just one parent, living alone, sex, and number of months as an intern were factors associated with the risk of alcohol use disorder. Conclusion: To reduce emotional eating and the risk of alcohol use disorder among interns, universities should implement interventions aimed at reducing the emotional impact of COVID-19 and provide nutritional counseling.

Global public health systems have continuously faced challenges from the advent of novel infectious illnesses, necessitating quick and efficient actions to stop their spread.First discovered in Saudi Arabia in 2012, Middle East respiratory syndrome (MERS) is a viral respiratory disorder caused by the Middle East respiratory syndrome coronavirus (MERS-CoV). Since then, the nation has reported most cases and fatalities related to this sickness, with occasional outbreaks happening in other nations and regions. Severe sickness and high mortality are caused by MERS-CoV, especially in older persons and those with underlying chronic conditions. Through intimate contact, the virus can spread from people to dromedary camels and vice versa. It has sparked multiple epidemics both domestically and abroad in the Middle East, raising the possibility of fatalities and widespread transmission, especially in susceptible groups. The Riyadh region was the main target of the most current MERS-CoV outbreak in Saudi Arabia, which began in 2023 and ended on September 1, 2023, with 312 confirmed cases and ninety-seven fatalities. With the use of published studies and their contributions to the field, we hope to present a thorough overview of the MERS-CoV outbreak in Saudi Arabia in this review of the literature, including its epidemiological investigation, public health response, impact, and lessons learned. In addition to highlighting the importance and continued relevance of this problem, our work suggests ways to lower the risk of MERS-CoV transmission and avert further outbreaks.

Patients with a psychotic disorder frequently report oral health problems, while mental health nurses (MHNs) seem not to be fully aware of these problems and the risk factors. Therefore, this study aims to develop supportive tools for MHNs regarding oral health to increase sensitization among MHNs and to provide MHNs with knowledge to recognize (potential) oral health problems in patients with a psychotic disorder. We used a human-centered design in which the user, MHNs as well as experts by experience, were placed in the centre of the research process. Problems and needs in MHNs working with patients with a psychotic disorder were addressed. To identify key issues of problem as well as the needs in terms of resources, we started with focus groups (n = 9). We analysed the data thematically based on context of patients and MHNs in practice regarding oral health, preferred oral health tools focused on MHN, and intended outcomes of tools. A Multi Criteria Decision Matrix was developed and analysed (n = 9) to identify the most optimal and viable solution based on established criteria and issues that are prevalent in the work of MHNs. Most promising result was the development of a brochure with an awareness screener. The brochure with awareness screener was developed as a low-fidelity prototype for MHNs regarding oral health in patients with a psychotic disorder, based on the latest scientific evidence. After testing it, the feasibility was tested through semi-structured interviews (n=19). MHNs and experts by experience were satisfied with the tool and provided recommendations for adjustments to the content. Significant augmentations to the brochure include a clinical lesson and a toothbrush with toothpaste for patients. We can conclude that a brochure with an awareness screener is feasible for MHNs. Future steps aiming to further refine and optimize care processes for oral health tools in MHNs, should take refining eligibility criteria for psychiatric populations and the language level of the target group of a tool into account.

User experience-related challenges play a significant part in user-technology interactions. However, design processes have not always kept up with the evolving needs of users in terms of technology interactions. This paper aims to present the design, structure and evaluation of an integrated mental health intervention platform (AMGR-I), emphasizing the importance of user-centred design and engagement in addressing the evolving needs of users in technology interactions, specifically focusing on individuals with mental health disorders. The AMGR-I pilot platform integrates community, e-learning, and care sub-platforms to provide a holistic approach to mental health intervention. The study utilizes participatory design research with targeted users to gather insights into user preferences and expectations. By involving the targeted audience in the design process, the platform’s user-centered design can be improved effectively. The platform recognizes the changing view of users, who now seek products that deliver pleasure, enjoyment, engagement, and embodiment. This research contributes to the field by highlighting the importance of user-centered design in the development of a comprehensive platform for mental health support.

Myocastor coypus is a pest animal present in Africa, Europe, North America, and Asia that causes agricultural and ecological damages. Moreover, it has to be considered as a potential risk for public health. Forty-four Nutrias from the “Parco Naturale La Mandria” (Piedmont region, Northwest Italy) have been analysed. A complete necropsy and a whole histological evaluation of liver, kidney and lung have been carried out on all the animals. Moreover, the positivity to Hepatitis E Virus (HEV), Encephalomyocarditis virus (EMCV), Francisella spp., Toxoplasma gondii and Neospora caninum have been investigated. None of the animal resulted positive for HEV, EMCV, Francisella spp. or Neospora caninum. Two animals tested positive for Toxoplasma gondii. A high presence of histological lesions has been identified in different organs, suggesting that lesions could be induced by different pathogens. As previously reported, Nutria can act as a host for several pathogens, including important agents for human and animal health, and surveillance is necessary, to fully understand the biological role and the importance of coypu as a disease reservoir in our country.